Utilization of services provided by village based ethnic minority midwives in mountainous villages of Vietnam

Figures & data

Table 1 Social demographic characteristics of study participants (N=320)

Characteristics	n	%
Age group
≤19 years	69	21.6
20–34 years	227	70.9
≥35 years	24	7.5
Number of children
1	113	35.3
≥2	207	64.7
Ethnic group
Hmong	139	43.4
Xo Dang	142	44.4
Others (Gia Rai, Ba Na, Khang, and Kho Mu)	39	12.2
Education
No school	110	34.4
Attended school	210	65.6
Household economic status
Poor	178	55.6
Nonpoor	142	44.4
Possession of health insurance
Yes	298	93.1
No	22	6.9
Distance to a nearest health facility
<5 km	225	70.3
≥5 km	95	29.7
Difficulty in accessing a nearest health facility in rainy season
No	128	40.0
Yes	192	60.0

Table 2 Utilization of maternal health services by services providers

Services	Service utilization (n, %)		Services provided by
			EMM (%)	Doctor (%)	Midwife (%)	Other health personnel (%)	Village health worker (%)
ANC
≥1 ANC	320	95.9	28.3	28.3	70.7	21.8	2.3
Counseling	320	84.7	35.8	19.5	66.9	22.1	9.9
Being supported by any health workers in case of having abnormal signs	36	11.3	19.4	27.8	25	11.1	5.6
Referred in case of having abnormal signs	23	63.9	26.1	–	–	–	–
Any supports in antenatal care services	320	98.4	33.4	30.6	70.3	26.6	8.8
Intrapartum care
Home delivery	320	62.2	21.6	0.1	2.0	0.5	6.5
Birth assisted by health workers	320	56.3	16.3	19.1	23.8	6.6	4.1
Being supported by any health workers in case of having abnormal signs	47	14.7	17.0	42.8	38.3	17.0	2.1
Referred in case of having abnormal signs	34	73.9	41.2	–	–	–	–
Any supports in delivery	320	58.4	20.3	19.7	25.3	8.4	4.4
Postpartum care
Postnatal counseling	320	73.8	37.3	11.0	26.7	9.7	22.9
Visits within 42 days after delivery	320	46.9	57.3	2.7	22.7	16.0	17.1
Being supported by any health workers in case of having abnormal signs	320	8.8	42.9	21.4	25.0	10.7	1
Newborn being supported by any health workers in case of having abnormal signs	31	9.7	12.9	38.7	9.7	22.6	3.2
Mother/child referred	34	65.4	32.4	–	–	–	–
Any postnatal care services	320	79.1	33.8	12.2	24.1	13.4	23.4
Any services	320	99.4	45.6	41.9	75	36.3	26.9

Abbreviations: ANC, antenatal care; EMM, ethnic minority midwife.

Table 3 Bivariate analysis of factors associated with the use of any services provided by EMMs

Characteristics	n (%)	Using EMM (yes, n, %)	P-value (χ^2)
Socioeconomic determinants
Age group			0.839
<20 years	54 (22.1)	31 (54.7)
≥20 years	190 (77.9)	112 (58.9)
Number of children			0.385
1	85 (34.8)	53 (62.4)
≥2	159 (65.2)	90 (56.6)
Ethnic group			0.037*
Hmong, Kho Mu, Khang	128 (52.5)	67 (52.3)
Xo Dang, Ba Na, Gia Lai	116 (47.5)	76 (65.5)
Education			0.096*
Never attended school	82 (33.6)	42 (51.2)
Attended school	162 (66.4)	101 (62.3)
Household economic status			0.223
Poor	144 (59.0)	89 (61.8)
Nonpoor	100 (41.0)	54 (54.0)
Knowledge and trust in EMM services
Knowledge about EMM services			0.034*
None of services	31 (12.7)	15 (48.4)
1–3 services	149 (87.3)	128 (55.0)
≥4 services	64 (26.2)	46 (71.9)
Knowledge that EMM was trained			0.005*
No	43 (17.6)	17 (39.5)
Yes	201 (82.4)	126 (62.7)
Source of information about EMM
Village leader			0.388
No	164 (67.2)	93 (56.7)
Yes	80 (32.8)	50 (62.5)
Village health worker			0.277
No	185 (75.8)	112 (60.5)
Yes	59 (24.2)	31 (52.5)
Health worker			0.078*
No	200 (92.0)	112 (56.0)
Yes	44 (18.0)	31 (70.5)
Mother/husband/relative			0.121
No	127 (52.0)	92 (57.9)
Yes	117 (48.0)	51 (60.0)
Perception that other mothers in a village know about services		EMM	<0.001*
A few or no one know	50 (20.1)	12 (24.0)
Many	194 (79.9)	131 (67.5)
Knowing where an EMM house is			<0.001*
No	25 (10.2)	2 (8.0)
Yes	219 (89.8)	141 (64.4)
Trust in EMM services			0.004*
Some of service provision	57 (23.4)	24 (42.1)
Most of service provision	187 (72.6)	119 (63.6)
Accessibility
Distance to a nearest health facility			0.789
≥5 km	87 (35.7)	50 (57.5)
<5 km	137 (64.3)	93 (59.2)
Difficulty of access to a nearest health facility during rainy season			0.157
No	85 (34.8)	55 (64.7)
Yes	159 (65.2)	88 (55.3)
Distance to an EMM’s house			0.009*
≥2 km	72 (21.8)	33 (45.8)
<2 km	172 (78.2)	110 (64.0)
Can call an EMM if needed			<0.001*
No	63 (25.8)	17 (27)
Yes	181 (74.2)	126 (69.6)

Note:

* P<0.05.

Abbreviation: EMM, ethnic minority midwife.

Table 4 Logistic regression analysis of factors associated with using any EMM services (n=244)

Variables	P-value	aOR (95% CI)
Ethnic group
Xo Dang, Ba Na, Gia Lai		1
Hmong, Kho Mu, Khang	0.65	0.53 (0.27–1.04)
Knowledge about EMMs from health workers
No		1
Yes	0.024	2.68 (1.14–6.31)
Perception that other mothers in a village know about EMMs
A few or no one know		1
Many	<0.001	4.91 (2.18–11.04)*
Trust in EMM services
Some of service provision		1
Most of service provision	0.002	3.36 (1.56–7.11)*
Knowing the location of an EMM’s house
No		1
Yes	<0.001	26.6 (5.02–140.7)*

Notes: P=0.8 (Hosmer & Lemeshow), 0.26 (Cox & Snell), 0.35 (Nagelkerke). Model χ²(7) =3.069.

* P<0.05.

Abbreviations: aOR, adjusted odds ratio; CI, confidence interval; EMM, ethnic minority midwife.