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  • 1
    Online Resource
    Online Resource
    Building HIV healthcare worker capacity through telehealth in Vietnam
    BMJ ; 2020
    In:  BMJ Global Health Vol. 5, No. 4 ( 2020-04), p. e002166-
    Details
    In: BMJ Global Health, BMJ, Vol. 5, No. 4 ( 2020-04), p. e002166-
    Abstract: Development of a robust technical assistance system is an essential component of a sustainable HIV response. Vietnam’s National HIV Program is transitioning from a largely donor-funded programme to one primarily supported by domestic resources. Telehealth interventions are increasingly being used for training, mentoring and expert consultation in high-resource settings and hold significant potential for use as a tool to build HIV health worker capacity in low and middle-income countries. We designed, implemented and scaled up a novel HIV telehealth programme for Vietnam, with the goal of building a sustainable training model to support the country’s HIV workforce needs. Over a 4-year period, HIV telehealth programmes were initiated in 17 public institutions with participation of nearly 700 clinical sites across 62 of the 63 provinces in the country. The telehealth programme was used to deliver certificate training courses, provide clinical mentoring and case-based learning, support programme implementation, provide coaching in quality improvement and disseminate new guidelines and policies. Programme evaluation demonstrated improved health worker self-reported competence in HIV care and treatment and high satisfaction among the programme participants. Lessons learnt from Vietnam’s experience with telehealth can inform country programmes looking to develop a sustainable approach to HIV technical assistance and health worker capacity building.
    Type of Medium: Online Resource
    ISSN: 2059-7908
    URL: Article
    DOI: 10.1136/bmjgh-2019-002166
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2851843-3
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  • 2
    Online Resource
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    Do beer and wine respond to price and tax changes in Vietnam? Evidence from the Vietnam Household Living Standards Survey
    BMJ ; 2019
    In:  BMJ Open Vol. 9, No. 5 ( 2019-05), p. e027076-
    Details
    In: BMJ Open, BMJ, Vol. 9, No. 5 ( 2019-05), p. e027076-
    Abstract: To provide the first ever published estimates of the price and expenditure elasticities of demand for beer and wine in Vietnam and thereby contribute to policy initiatives aimed at reducing the excessive consumption of alcohol. Methods We use a linear approximation of the Almost Ideal Demand System and data from the Vietnam Household Living Standards Survey for 2010, 2012 and 2014. Results We find that the demand for beer and wine in Vietnam is price and expenditure inelastic with average price elasticities of −0.283 and −0.317 and average expenditure elasticities of 0.401 and 0.156, respectively. That is, we find that beer and wine consumption decline whenever their respective prices increase and their consumption increases whenever expenditure rises. Conclusions The results of the study lend confidence to calls for increased taxation of alcoholic products on public health grounds in Vietnam.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2018-027076
    Language: English
    Publisher: BMJ
    Publication Date: 2019
    detail.hit.zdb_id: 2599832-8
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  • 3
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    Online Resource
    Factors related to intracerebral haematoma in patients with aneurysmal subarachnoid haemorrhage in Vietnam: a multicentre prospective cohort study
    BMJ ; 2023
    In:  BMJ Open Vol. 13, No. 4 ( 2023-04), p. e066186-
    Details
    In: BMJ Open, BMJ, Vol. 13, No. 4 ( 2023-04), p. e066186-
    Abstract: To investigate the impact of intracerebral haematoma (ICH) on the outcomes and the factors related to an ICH in patients with aneurysmal subarachnoid haemorrhage (aSAH) in a low- and middle-income country. Design A multicentre prospective cohort study. Setting Three central hospitals in Hanoi, Vietnam. Participants This study included all patients (≥18 years) presenting with aSAH to the three central hospitals within 4 days of ictus, from August 2019 to June 2021, and excluded patients for whom the admission Glasgow Coma Scale was unable to be scored or patients who became lost at 90 days of follow-up during the study. Outcome measures The primary outcome was ICH after aneurysm rupture, defined as ICH detected on an admission head CT scan. The secondary outcomes were 90-day poor outcomes and 90-day death. Results Of 415 patients, 217 (52.3%) were females, and the median age was 57.0 years (IQR: 48.0–67.0). ICH was present in 20.5% (85/415) of patients with aSAH. There was a significant difference in the 90-day poor outcomes (43.5% (37/85) and 29.1% (96/330); p=0.011) and 90-day mortality (36.5% (31/85) and 20.0% (66/330); p=0.001) between patients who had ICH and patients who did not have ICH. The multivariable regression analysis showed that systolic blood pressure (SBP) ≥140 mm Hg (adjusted odds ratio (AOR): 2.674; 95% CI: 1.372 to 5.214; p=0.004), World Federation of Neurosurgical Societies (WFNS) grades II (AOR: 3.683; 95% CI: 1.250 to 10.858; p=0.018) to V (AOR: 6.912; 95% CI: 2.553 to 18.709; p 〈 0.001) and a ruptured middle cerebral artery (MCA) aneurysm (AOR: 3.717; 95% CI: 1.848 to 7.477; p 〈 0.001) were independently associated with ICH on admission. Conclusions In this study, ICH was present in a substantial proportion of patients with aSAH and contributed significantly to a high rate of poor outcomes and death. Higher SBP, worse WFNS grades and ruptured MCA aneurysms were independently associated with ICH on admission.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    URL: Article
    DOI: 10.1136/bmjopen-2022-066186
    DOI: 10.1136/bmjopen-2022-066186.supp1
    Language: English
    Publisher: BMJ
    Publication Date: 2023
    detail.hit.zdb_id: 2599832-8
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  • 4
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    Online Resource
    Assessing feasibility of establishing antimicrobial stewardship programmes in two provincial-level hospitals in Vietnam: an implementation research study
    BMJ ; 2021
    In:  BMJ Open Vol. 11, No. 10 ( 2021-10), p. e053343-
    Details
    In: BMJ Open, BMJ, Vol. 11, No. 10 ( 2021-10), p. e053343-
    Abstract: To investigate the feasibility of establishing hospital-based antimicrobial stewardship (AMS) programmes comprising action-planning, educational interventions and data feedback in two provincial-level hospitals in Viet Nam. Design and setting This was an implementation research using participatory action process and existing resources from the Duke Antimicrobial Stewardship Outreach Network with local adjustments. A national stakeholder meeting and Strengths-Weaknesses-Opportunities-Threats (SWOT) analysis were conducted to identify gaps and potential interventions. Participants Hospital AMS staff implemented activities throughout the study phases. Routinely collected patient data were analysed to support planning, implementation and evaluation. Interventions Hospitals were considered as a complex adaptive system and leveraged their unique characteristics and interconnections to develop 1-year plans containing core interventions (data use, educational training, prospective audit with feedback (PAF) and evaluations). Outcome measures We assessed feasibility using outputs from stakeholder meeting, SWOT analysis, baseline data, planning process and implementation. Results The stakeholder meeting identified three gaps for AMS at national level: supportive policies, AMS training and core competencies and collaboration. At the hospitals, AMS programmes took 1 year for planning due to lack of hospital-specific procedures and relevant staff competencies. Baseline data (January–December 2019) showed variations in antibiotic consumption: 951 days of therapy (DOT) per 1000 days present in the control and 496 in the intervention wards in hospital 1, and 737 and 714 in hospital 2, respectively. During 1-year implementation, clinical pharmacists audited 1890 antibiotic prescriptions in hospital 1 (June 2020–May 2021) and 1628 in hospital 2 (July 2020–July 2021), and will continue PAF in their daily work. Conclusion Our data confirmed the need to contextualise AMS programmes in low-income and middle-income countries (LMICs) and demonstrated the usefulness of implementation research design in assessing programme feasibility. Developing staff competencies, using local data to stimulate actions and integrating programme activities in routine hospital work are key to success in LMICs.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2021-053343
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 2599832-8
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  • 5
    Online Resource
    Online Resource
    Type 2 diabetes and hypertension in Vietnam: a systematic review and meta-analysis of studies between 2000 and 2020
    BMJ ; 2022
    In:  BMJ Open Vol. 12, No. 8 ( 2022-08), p. e052725-
    Details
    In: BMJ Open, BMJ, Vol. 12, No. 8 ( 2022-08), p. e052725-
    Abstract: The objective of this study was to determine the level of type 2 diabetes (T2DM) and hypertension (HTN) in Vietnam and to assess the trend and recommend the future direction of prevention research efforts. Design We searched scientific literature, databases including PubMed, EMBASE, CINHAL and Google Scholar; grey literature and reference lists for primary research published, nation database websites between 1 January 2000 and 30 September 2020. We adapted the modified Newcastle Ottawa Scale for assessing the quality of the study, as recommended by the Cochrane Collaboration. Results In total, 83 studies met our inclusion criteria, representing data of approximately 239 034 population of more than 15 years of age in Vietnam. The findings show that prevalence rates varied widely across studies, from 1.0% to 29.0% for T2DM and 2.0% to 47.0% for HTN. For the total study period, pooled prevalence of T2DM and HTN in Vietnam for all studies was 6.0% (95% CI: 4.0% to 7.0%) and 25% (95% CI: 19% to 31%), respectively. Prevalence rate of both T2DM and HTN was higher among the male population compared with female counterpart. Conclusion There is evidence of a rising trend of HTN and T2DM prevalence in Vietnam. Future research should focus on the major drivers, incidence and prognosis of T2DM and HTN. Policy approaches should base upon the trends of T2DM and HTN in Vietnam over the last 20 years and pay more attention on the effective interventions to combat T2DM and HTN. In our study, we included both English and Vietnamese language articles and seems that majority of the articles came from Vietnamese language. PROSPERO registration number CRD42020182959.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    URL: Article
    DOI: 10.1136/bmjopen-2021-052725
    DOI: 10.1136/bmjopen-2021-052725.supp1
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 2599832-8
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  • 6
    Online Resource
    Online Resource
    Empirical analysis on the illicit trade of cigarettes in Vietnam
    BMJ ; 2020
    In:  Tobacco Control Vol. 29, No. Suppl 4 ( 2020-10), p. s281-s286
    Details
    In: Tobacco Control, BMJ, Vol. 29, No. Suppl 4 ( 2020-10), p. s281-s286
    Abstract: This paper examined how a higher tax on tobacco would affect illicit trade in Vietnam. Methodology and data This paper used the gap method to estimate the gap between cigarette domestically tax-paid sales and domestic consumption. Data were from the tax-paid sales by the Vietnam Steering Committee on Smoking and Health (VINACOSH), the Vietnam Tobacco Association, the General Tax Department, as well as two rounds of the Global Adult Tobacco Survey in 2010 and 2015. Key results The results indicated that Vietnam had a negative volume of illicit trade, either a result of under-reporting of tobacco use or due to net smuggling of tax-paid cigarettes out of the country. Furthermore, the trend showed an increased negative volume over time, which indicated that increases in tobacco taxes in the interleading years did not result in an increase in illicit trade in tobaccos in Vietnam. Conclusions Vietnam’s low prices on domestic cigarettes created favourable conditions for cigarette smugglers and provided easy access to illicit cigarettes for the Vietnamese people, but the absence of a relationship between tax changes and smuggling suggested that potential increases in the excise tax should not be discouraged by the threat of an increase in illicit trade. The government should increase taxes on cigarettes to raise domestic cigarette prices and take strong policy measures to create a more transparent social environment, therefore effectively reducing the prevalence of illicit cigarettes in Vietnam.
    Type of Medium: Online Resource
    ISSN: 0964-4563 , 1468-3318
    URL: Article
    DOI: 10.1136/tobaccocontrol-2019-055598
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2010882-5
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