ARH Adolescent Reproductive HealthCDK Clean Delivery KitCHC Commune Health CentresCM-5 Child Mortality Under 5CPR Contraceptive Prevalence RateD&C Dilatation and CurettageD&E Gestation D
Topic distribution
A total of 221 studies were included in this review The distributions of these studies according to their topics are presented in Table 1.
The majority of research concentrated on safe motherhood (26.87%), with significant attention also given to family planning (18.2%), gender and sexuality (13.6%), and reproductive tract infections/sexually transmitted infections (10.5%) In contrast, topics such as abortion and adolescent health received limited exploration, accounting for approximately 10%, while areas like menopause, infertility, reproductive cancers, and information, education, and communication (IECs) were even less represented in the studies.
Research priorities have consistently highlighted safe motherhood and family planning, leading to a significant focus on these areas In contrast, issues like menopause, infertility, and reproductive cancers have only recently gained attention and lack clear targets in the reproductive health strategy from 2001 to 2010 Given that reproductive cancers, particularly breast and cervical cancer, are leading causes of mortality among women, it is crucial that these topics receive increased focus in future research efforts.
Study participants
Over half of the studies included mixed-gender participants, while approximately one-third focused solely on women, and a small number concentrated exclusively on men (Table 2) Historically, maternal and child health (MCH) initiatives primarily targeted women; however, following the International Conference on Population and Development (ICPD), the focus broadened to encompass both men and women, as evidenced by the diverse participant demographics.
Abortion Adolescents Gender & sexuality IEC
Menopause Infertility and reproductive cancers Safe motherhood
Table 1 Distribution of topics in RH
Strictly men Strictly women Mixed
Research focusing exclusively on men is limited, accounting for only 2.6% of studies, and often addresses sensitive issues like sexuality and infertility However, engaging men in reproductive health is a crucial strategy of the International Conference on Population and Development (ICPD) Consequently, there is a strong recommendation for more research to investigate men's perspectives on reproductive health.
The studies included a diverse participant range, from adolescents to the elderly, with 42.7% of participants in their reproductive years, 15.4% menopausal or elderly, and 11.5% adolescents This distribution aligns with the focus on reproductive health topics relevant to these age groups However, as Vietnam is moving towards an aging population, there is a pressing need for more research on menopausal and elderly individuals.
Research methods
Study design is summarized in Table 4.
Different types of studies were applied to
Recent research in the field of RH indicates that a significant portion of studies, specifically 42.7%, employed cross-sectional designs This was followed by qualitative approaches at 18.5% and evaluation, review, or assessment methods at approximately 15.9% Other research designs, including clinical, intervention, cohort, or longitudinal studies, were utilized to a lesser extent, accounting for 8.8%.
The proportion of studies classified as high evidence, including randomized controlled trials (RCTs), interventions, cohort studies, and longitudinal studies, is notably low, accounting for less than 15% of all research conducted.
Research findings on reproductive health, including medical abortion and reproductive cancer, would gain significantly enhanced reliability if methodologies like clinical trials and longitudinal studies were utilized.
While implementing these designs has proven challenging, it is essential to consider their potential Future studies should be conducted with adequate funding and resources to provide evidence-based information for policymakers.
Most studies focused on factors associated with conditions under investigation (63.9%), followed by prevalence of conditions (20.3%) and knowledge - attitude - practice (KAP) (13.7%) Least was mortality/morbidity (1.8%) (Table 5).
This distribution bears noting A low number of studies used the epidemiological approach to identify the prevalence or
Adolescents Reproductive age Menopausal/elderly Other
Clinical trial Intervention Cohort study Longitudinal study Cross-sectional Rapid appraisal Assessment -evaluation - review Explanatory study/open label study Secondary data analysis including census Qualitative study
100% mortality or morbidity The majority of researchers tried to explain the KAP and factors associated with condition
To effectively develop intervention strategies for public health issues, initial studies must focus on explanatory research with an epidemiological approach to determine the prevalence of these problems After establishing prevalence, it is crucial to gain a deeper understanding through studies on Knowledge, Attitudes, and Practices (KAP) or associated factors While many reproductive health issues, like family planning and safe motherhood, have well-documented prevalence and have been further explored for KAP, emerging issues such as gender-based violence, infertility, reproductive cancers, and menopause also require careful prevalence identification.
Study setting
Most studies examined both rural and urban areas (42.3%), with a smaller focus on rural only (26.9%) and urban only (17.2%) as shown in Table 6 This indicates a significant interest in both settings; however, research highlights that RH indicators are more favorable in urban areas compared to rural and remote regions Consequently, there is a need for increased research attention on remote and rural areas.
Report quality
Definition of the health topic:
Ethics approval Data collection timeframe Data analysis
The quality of reports was reviewed for several items, such as definition of conditions, sampling, timeframe of data collection, data analysis, and ethics (Table 7).
Over half of the studies (57%) clearly defined the conditions under investigation, as shown in Table 7 For instance, studies on medical abortion should explicitly outline the definition, including inclusion and exclusion criteria However, nearly half of the studies failed to provide this clarity, complicating the reviewers' ability to assess participant selection Future research proposals and report writing should prioritize this improvement.
Approximately one-third of studies employed random sampling, while another third utilized convenient sampling, and one-fifth used other methods; a small number did not disclose their sampling techniques Although random sampling enhances the interpretability of study results, its practical application is often challenging Consequently, researchers must exercise caution when interpreting and generalizing findings from studies that do not use random sampling and may not accurately represent the target population.
About three-fourths of studies provided data collection time (77.5%) This figure should be improved in the future
Approximately one-third of studies employed basic statistical techniques, while another third utilized bivariate analysis, and only 16.3% incorporated multivariate analysis Although cross-sectional studies typically do not facilitate the evaluation of cause-and-effect relationships, they can generate hypotheses regarding these relationships when appropriate multivariate analysis strategies are applied Basic frequency and bivariate analyses fall short in offering meaningful insights into variable relationships, highlighting the need for enhanced data analysis skills in future research.
Many studies have utilized qualitative data collection and analysis, often combining qualitative and quantitative approaches However, few have employed purely qualitative methods This approach has enabled researchers to gain valuable insights into sensitive issues in the Vietnamese context, including premarital sex, abortion, sexuality, and gender Consequently, there is a need for further exploration of qualitative methods in future research.
Only about one-third of studies reported approval of the ethical approval of the work.
Bioethics is an emerging concept among researchers in Vietnam, with limited representation in existing studies However, there is significant potential for growth in this field, especially in research addressing sensitive topics such as abortion, sexuality, and gender It is crucial to ensure the confidentiality and privacy of participants in all studies.
V Findings Of Reproductive Health Studies
Each year, approximately 529,000 women die from preventable causes related to pregnancy and childbirth, predominantly in developing countries, with millions more suffering from health issues and disabilities In response to these alarming statistics, the global Initiative on Safe Motherhood was launched in 1987 during a conference in Nairobi, Kenya, aiming to raise awareness about maternal mortality and morbidity Since then, global efforts have intensified to enhance maternal health, including the establishment of the Millennium Development Goals (MDGs), which focus on improving maternal and child health care.
In response to the Millennium Development Goals aimed at enhancing maternal health, this global initiative highlights effective and innovative strategies designed to improve maternal health outcomes.
On November 28, 2000, the Prime Minister of Vietnam signed Decision No 136/2000/QD-TTg, which established the National Strategy on Reproductive Health for 2001-2010 This decision aims to achieve the objectives outlined in the Programme of Actions from the International Population and Development Conference held in Cairo in 1994.
Safe motherhood is a crucial component of Vietnam's National Strategy on Reproductive Health, with significant progress made in this area The establishment of the National Master Plan on Safe Motherhood for 2003-2010 marks a vital step in effectively implementing the National Strategy for Reproductive Health Care from 2001 to 2010, thereby supporting the achievement of national development goals in the 21st century The National Strategy for Reproductive Health Care outlines four primary objectives to be accomplished by 2010.
- Reducing maternal mortality rate (MMR) by 50% (from 165 to 70/100,000 live births)
- Reducing perinatal mortality rate by 20% (22.2‰to 18.8‰)
- Reducing infant mortality rate (IMR) from 36.7‰to 25‰
- Reducing low birth weight (LBW) by 25% (from 8% to 6%)
Safe Motherhood means ensuring that all women receive the care they need to be safe and healthy throughout pregnancy and childbirth
The Safe Motherhood Program encompasses essential services such as antenatal care (ANC), delivery care, neonatal care, and post-partum care (PNC) It also addresses safe abortion, prevention and control of reproductive tract infections (RTIs), sexually transmitted diseases, and the prevention of mother-to-child HIV transmission Additionally, the program promotes family planning following childbirth.
Promoting health is a key component of the National Strategy for Reproductive Health in Vietnam, aligning with the government's efforts to achieve the Millennium Development Goals (MDGs) This strategy emphasizes safe motherhood, specifically targeting the reduction of maternal and neonatal/perinatal mortality rates.
This review section focused on maternal mortality, perinatal mortality, ANC, delivery and postpartum care, neonatal care and service provision for safe motherhood programs.
Other issues such as abortion, family planning and RTIs were reported in other corresponding sections.
Maternal mortality refers to the death of a woman during pregnancy or within 42 days after the end of pregnancy, regardless of the duration or location of the pregnancy This definition encompasses deaths caused by or worsened by pregnancy or its management, excluding accidental or incidental causes.
The Maternal Mortality Ratio (MMR) in Vietnam varies significantly, with reported figures of 85, 165, and 130 deaths per 100,000 live births These discrepancies highlight issues related to data accuracy and reliability.
A national survey on maternal mortality across seven ecological regions in Vietnam revealed significant disparities and challenges in maternal health The maternal mortality rate (MMR) varied widely, with a low rate of 45 per 100,000 live births in the Red River Delta, contrasting sharply with a high rate of 411 per 100,000 in mountainous provinces like Cao Bang Additionally, provincial studies reported an MMR of 52.5 per 100,000 in Danang, while hospital data indicated an alarming rate of 56.3 maternal deaths per 100,000 live births among pregnant women.
Maternal mortality encompasses all deaths associated with pregnancy, including indirect causes, making accurate measurement challenging and costly The rates and ratios of maternal mortality are often unreliable due to under-reporting and misclassification, as many deaths occur outside the healthcare system, complicating accurate death registration Research indicates that the true number of maternal deaths can be two to three times higher than reported figures.