Publications by authors named "Van Minh Hoang"

124 Publications

Financial toxicity due to breast cancer treatment in low- and middle-income countries: evidence from Vietnam.

Support Care Cancer 2021 Apr 16. Epub 2021 Apr 16.

Centre for Public Health, Queen's University Belfast, Belfast, UK.

Background: This study examined the financial toxicity faced by breast cancer (BC) patients in Vietnam and the factors associated with the risk and degree of that toxicity.

Methods: A total of 309 BC patients/survivors completed an online survey (n=209) or a face-to-face interview (n=100) at two tertiary hospitals. Descriptive statistics and χ tests were used to identify and analyse the forms and degree of financial toxicity faced by BC patients/survivors. A Cragg hurdle model assessed variation in risk and the degree of financial toxicity due to treatment.

Results: 41% of respondents faced financial toxicity due to BC treatment costs. The mean amount of money that exceeded BC patients/survivors' ability to pay was 153 million Vietnamese Dong (VND) ($6602) and ranged from 2.42 million VND to 1358 million VND ($104-58,413). A diagnosis at stage II or III of BC was associated with 16.0 and 18.0 million VND (~$690-777) more in the degree of financial toxicity compared with patients who were diagnosed at stage 0/I, respectively. Being retired or married or having full (100%) health insurance was associated with a decrease in the degree of financial toxicity.

Conclusions: A significant proportion of Vietnamese BC patients/survivors face serious financial toxicity due to BC treatment costs. There is a need to consider the introduction of measures that would attenuate this hardship and promote uptake of screening for the reduction in financial toxicity as well as the health gains it may achieve through earlier detection of cancer.
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http://dx.doi.org/10.1007/s00520-021-06210-zDOI Listing
April 2021

Coping strategies and social support among caregivers of patients with cancer: a cross-sectional study in Vietnam.

AIMS Public Health 2021 11;8(1):1-14. Epub 2020 Dec 11.

Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam.

Research on coping strategies and social support among Vietnamese cancer caregivers remains limited. In this study, we aim to examine the relationships between types of coping strategies utilized and social support among cancer caregivers. This was a cross-sectional study conducted in three main cancer hospitals in the Northern, Central and Southern regions of Vietnam. The 28-item Brief COPE Inventory (BCI) Scale and the Multidimensional Scale of Perceived Social Support (MSPSS) were utilized. Descriptive statistics and multivariate linear regression were performed. Active coping, acceptance and positive reframing were the most used coping strategies among participants, while substance use was the least commonly used. Level of social support was positively correlated with the utilization of coping mechanisms. Receiving high social support and utilizing positive coping strategies enables caregivers to mitigate their caregiving burden, control the situation and enhance their own quality of life.
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http://dx.doi.org/10.3934/publichealth.2021001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7870390PMC
December 2020

Anxiety among the Vietnamese Population during the COVID-19 Pandemic: Implications for Social Work Practice.

Soc Work Public Health 2021 02 17;36(2):142-149. Epub 2021 Jan 17.

Department of Policy and Health Economics, Hanoi University of Public Health, Hanoi city, Vietnam.

The COVID-19 pandemic is a global health crisis and threatening human lives, especially vulnerable groups. This study aimed to estimate the prevalence of self-reported anxiety and to examine associated factors among the Vietnamese population during the COVID-19 pandemic. A cross-sectional study in Vietnam was conducted in April 2020. An online survey was used to do the rapid assessment. Among 1,249 participants, the prevalence of self-reported anxiety was 8.5%. In the multivariable regression models, significant factors for self-reported anxiety were people aged 60 years old or older, rural areas, and COVID-related music-video-watching. Implications for social work practice were also discussed.
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http://dx.doi.org/10.1080/19371918.2020.1871461DOI Listing
February 2021

Prevalence of smoking among health science students in Vietnam in 2018 and associated factors: A cross-sectional study.

Health Psychol Open 2020 Jul-Dec;7(2):2055102920967244. Epub 2020 Oct 28.

Hanoi University of Public Health, Vietnam.

Smoking is a global health problem among health science students. The objectives of this study were to estimate the prevalence of smoking and to examine associated factors among health science students from five universities in Vietnam. Among 5946 participants (95.0% response rate), the smoking prevalence was 19.2% (95% CI:17.4-21.0%) among male students and 2.9% (95% CI:2.4-3.5%) among female students. In the multivariable regression models, significant factors for smoking were the perceived financial burden, the respondent's year in university, a non-self-determined motivation profile, self-reported depression and/or anxiety, the level of vigorous physical activity, and alcohol drinking.
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http://dx.doi.org/10.1177/2055102920967244DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7597576PMC
October 2020

Patterns of behavioral risk factors for non-communicable diseases in Vietnam: A narrative scoping review.

Health Psychol Open 2020 Jul-Dec;7(2):2055102920967248. Epub 2020 Oct 23.

Vietnam Association of Psychology, Hanoi, Vietnam.

This review describes both magnitude and patterns of major behavioral risk factors for NCDs. Positive changes in tobacco use were identified, though this is far to meet the established expectation. Harmful alcohol consumption was reported, especially for males. Only small proportion of the population consumed an adequate amount of fruits and vegetables daily. Average salt intake was approximately doubled, in comparison to WHO's recommendations. Physical activity has shifted gradually negatively, but future trends are unpredictable. An organized surveillance system should be developed initially with adequate tools and public resources to maintain and ensure sustainability over time.
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http://dx.doi.org/10.1177/2055102920967248DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7588771PMC
October 2020

Effectiveness of clinical breast examination as a 'stand-alone' screening modality: an overview of systematic reviews.

BMC Cancer 2020 Nov 9;20(1):1070. Epub 2020 Nov 9.

Centre for Public Health, Queen's University Belfast, Belfast, UK.

Background: There is uncertainty about the effectiveness of clinical breast examination (CBE) and conflicting recommendations regarding its usefulness as a screening tool for breast cancer. This paper provides an overview of systematic reviews that assessed the effectiveness of CBE as a 'stand-alone' screening modality for breast cancer compared to no screening and focused on its value in low- and middle-income countries (LMICs).

Methods: We searched MEDLINE, EMBASE, Scopus, Web of Science, and the Cochrane Database of Systematic Reviews for systematic reviews reporting the effectiveness of CBE published prior to October 29, 2019. The main outcomes assessed were mortality and down staging. The AMSTAR 2 checklist was used to assess the methodological quality of the reviews including risk of bias.

Results: Eleven systematic reviews published between 1993 and 2019 were identified. There was no direct evidence that CBE reduced breast cancer mortality. Indirect evidence suggested that a well-performed CBE achieved the same effect as mammography regarding mortality despite its apparently lower sensitivity (40-69% for CBE vs 77-95% for mammography). Greater sensitivity was recorded among younger and Asian women. Moreover, CBE contributed between 17 and 47% of the shift from advanced to early stage cancer.

Conclusions: CBE merits attention from health system and service planners in LMICs where a national screening programme based on mammography would be prohibitively expensive. In particular, it is likely that considerable value would be gained from conducting implementation scientific research in countries with large numbers of Asian women and/or where younger women are at higher risk.

Registration: PROSPERO, registration number CRD42019126798 .
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http://dx.doi.org/10.1186/s12885-020-07521-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7653771PMC
November 2020

Rapid response to the COVID-19 pandemic: Vietnam government's experience and preliminary success.

J Glob Health 2020 Dec;10(2):020502

Hanoi University of Public Health, Hanoi, Vietnam.

Background: The COVID-19 pandemic has hit all corners of the world, challenging governments to act promptly in controlling the spread of the pandemic. Due to limited resources and inferior technological capacities, developing countries including Vietnam have faced many challenges in combating the pandemic. Since the first cases were detected on 23 January 2020, Vietnam has undergone a 3-month fierce battle to control the outbreak with stringent measures from the government to mitigate the adverse impacts. In this study, we aim to give insights into the Vietnamese government's progress during the first three months of the outbreak. Additionally, we relatively compare Vietnam's response with that of other Southeast Asia countries to deliver a clear and comprehensive view on disease control strategies.

Methods: The data on the number of COVID-19 confirmed and recovered cases in Vietnam was obtained from the Dashboard for COVID-19 statistics of the Ministry of Health (https://ncov.vncdc.gov.vn/). The review on Vietnam's country-level responses was conducted by searching for relevant government documents issued on the online database 'Vietnam Laws Repository' (https://thuvienphapluat.vn/en/index.aspx), with the grey literature on Google and relevant official websites. A stringency index of government policies and the countries' respective numbers of confirmed cases of nine Southeast Asian countries were adapted from the Oxford COVID-19 Government Response Tracker (https://www.bsg.ox.ac.uk/research/research-projects/coronavirus-government-response-tracker). All data was updated as of 24 April 2020.

Results: Preliminary positive results have been achieved given that the nation confirmed no new community-transmitted cases since 16 April and zero COVID-19 - related deaths throughout the 3-month pandemic period. To date, the pandemic has been successfully controlled thanks to the Vietnamese government's prompt, proactive and decisive responses including mobilization of the health care systems, security forces, economic policies, along with a creative and effective communication campaign corresponding with crucial milestones of the epidemic's progression.

Conclusions: Vietnam could be one of the role models in pandemic control for low-resource settings. As the pandemic is still ongoing in an unpredictable trajectory, disease control measures should continue to be put in place in the foreseeable short term.
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http://dx.doi.org/10.7189/jogh.10.020502DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7567433PMC
December 2020

Addressing Unintentional Exclusion of Vulnerable and Mobile Households in Traditional Surveys in Kathmandu, Dhaka, and Hanoi: a Mixed-Methods Feasibility Study.

J Urban Health 2021 Feb 27;98(1):111-129. Epub 2020 Oct 27.

Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK.

The methods used in low- and middle-income countries' (LMICs) household surveys have not changed in four decades; however, LMIC societies have changed substantially and now face unprecedented rates of urbanization and urbanization of poverty. This mismatch may result in unintentional exclusion of vulnerable and mobile urban populations. We compare three survey method innovations with standard survey methods in Kathmandu, Dhaka, and Hanoi and summarize feasibility of our innovative methods in terms of time, cost, skill requirements, and experiences. We used descriptive statistics and regression techniques to compare respondent characteristics in samples drawn with innovative versus standard survey designs and household definitions, adjusting for sample probability weights and clustering. Feasibility of innovative methods was evaluated using a thematic framework analysis of focus group discussions with survey field staff, and via survey planner budgets. We found that a common household definition excluded single adults (46.9%) and migrant-headed households (6.7%), as well as non-married (8.5%), unemployed (10.5%), disabled (9.3%), and studying adults (14.3%). Further, standard two-stage sampling resulted in fewer single adult and non-family households than an innovative area-microcensus design; however, two-stage sampling resulted in more tent and shack dwellers. Our survey innovations provided good value for money, and field staff experiences were neutral or positive. Staff recommended streamlining field tools and pairing technical and survey content experts during fieldwork. This evidence of exclusion of vulnerable and mobile urban populations in LMIC household surveys is deeply concerning and underscores the need to modernize survey methods and practices.
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http://dx.doi.org/10.1007/s11524-020-00485-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7873174PMC
February 2021

Overweight and obesity among Vietnamese school-aged children: National prevalence estimates based on the World Health Organization and International Obesity Task Force definition.

PLoS One 2020 12;15(10):e0240459. Epub 2020 Oct 12.

Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam.

Background: Overweight and obesity is a severe global health issue in both developed and developing nations. This study aims to estimate the national prevalence of overweight and obesity among school-aged children in Vietnam.

Method: We conducted a national cross-sectional study on 2788 children aged from 11-14 years old from September to November 2018. We applied the WHO 2007 and IOTF criteria to estimate the prevalence of overweight and obesity among participants. Poison regression analysis with cluster sampling adjustment was employed to assess associated factors with obesity and overweight. Metadata on sociodemographic characteristics, physical measurements, and lifestyle behaviors were also extracted to investigate these factors in association with overweight and obesity prevalence.

Results: The prevalences of overweight and obesity in Vietnamese children were 17.4% and 8.6%, respectively by WHO Z-score criteria, and 17.1% and 5.4%, according to the IOTF reference. Using WHO Z-score yielded a higher prevalence of obesity than the IOTF and CDC criteria of all ages and both sexes. The proportions of overweight and obesity were substantially higher among boys than girls across ages. Parental BMI was shown to be a significant factor associated with overweight/obesity status in both girls and boys. Only for boys, age (PR = 0.83, 95% CI 0.76-0.90) and belonging to ethnic minorities (PR = 0.43, 95% CI 0.24-0.76) were significant risk factors for overweight/obesity.

Conclusion: Our findings indicate a high prevalence of childhood overweight and obesity in Vietnam, especially in boys.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0240459PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7549813PMC
December 2020

Self-reported non-communicable diseases and associated socio-demographic status among ethnic minority populations in Vietnam, 2019.

Health Psychol Open 2020 Jul-Dec;7(2):2055102920954707. Epub 2020 Sep 10.

Hanoi University of Public Health, Hanoi, Vietnam.

The aim of this study was to report the prevalence of self-reported non-communicable diseases among ethnic minority populations in Vietnam and related factors. A total of 5033 individuals aged 15 years and older who belonged to ethnic minority populations from 12 provinces in Vietnam completed a household survey. The overall prevalence of self-reported non-communicable diseases was 12.4% (95% CI: 11.5%-13.4%). Cardiovascular diseases were the most prevalent, followed by diabetes. Ethnicity was shown to have an independently significant correlation to having any non-communicable diseases. Older people, near-poor and non-poor people had significantly higher odds of having non-communicable diseases as compared to younger and poor people.
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http://dx.doi.org/10.1177/2055102920954707DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7495520PMC
September 2020

Tobacco and Alcohol Use Among Ethnic Minorities in Vietnam.

Asia Pac J Public Health 2020 11 10;32(8):387-397. Epub 2020 Sep 10.

Hanoi University of Public Health, Hanoi, Vietnam.

This study investigates the prevalence of tobacco and alcohol uses and associated factors among 12 ethnic minorities in Vietnam in 2019. A cross-sectional survey was conducted among 5172 people aged ≥15 years. The prevalence of smoking and drinking was 19.7% and 29.9%, respectively, and significantly higher among men than women. These numbers were heterogeneous across ethnic minorities. Smoking prevalence was high among Ba Na (25.9%), Cham An Giang (22.3%), Khmer (23.5%), La Hu (26.3%), Ta Oi (30.7%), and Bru Van Kieu (29.6%) ethnicities whereas that of Gie Trieng and Mnong ethnicities was low (3.7% and 9.5%, respectively). Drinking prevalence ranged from 1.4% in Cham An Giang ethnicity to 68.6% in Ba Na ethnicity. A wide ethnic disparity on tobacco and alcohol use could be explained by the ethnic variation of lifestyles, social norms, and cultural features. Our findings suggest the need to develop ethnic-specific interventions to mitigate the smoking and drinking prevalence.
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http://dx.doi.org/10.1177/1010539520956444DOI Listing
November 2020

A qualitative assessment of factors influencing implementation and sustainability of evidence-based tobacco use treatment in Vietnam health centers.

Implement Sci 2020 09 9;15(1):73. Epub 2020 Sep 9.

Department of Public Health Policy and Management, School of Global Public Health, New York University, 715 Broadway, New York, NY, 10012, USA.

Background: Effective strategies are needed to increase implementation and sustainability of evidence-based tobacco dependence treatment (TDT) in public health systems in low- and middle-income countries (LMICs). Our two-arm cluster randomized controlled trial (VQuit) found that a multicomponent implementation strategy was effective in increasing provider adherence to TDT guidelines in commune health center (CHCs) in Vietnam. In this paper, we present findings from a post-implementation qualitative assessment of factors influencing effective implementation and program sustainability.

Methods: We conducted semi-structured qualitative interviews (n = 52) with 13 CHC medical directors (i.e., physicians), 25 CHC health care providers (e.g., nurses), and 14 village health workers (VHWs) in 13 study sites. Interviews were transcribed and translated into English. Two qualitative researchers used both deductive (guided by the Consolidated Framework for Implementation Research) and inductive approaches to analysis.

Results: Facilitators of effective implementing of TDT included training and point-of-service tools (e.g., desktop chart with prompts for offering brief counseling) that increased knowledge and self-efficacy, patient demand for TDT, and a referral system, available in arm 2, which reduced the provider burden by shifting more intensive cessation counseling to a trained VHW. The primary challenges to sustainability were competing priorities that are driven by the Ministry of Health and may result in fewer resources for TDT compared with other health programs. However, providers and VHWs suggested several options for adapting the intervention and implementation strategies to address challenges and increasing engagement of local government committees and other sectors to sustain gains.

Conclusion: Our findings offer insights into how a multicomponent implementation strategy influenced changes in the delivery of evidence-based TDT. In addition, the results illustrate the dynamic interplay between barriers and facilitators for sustaining TDT at the policy and community/practice level, particularly in the context of centralized public health systems like Vietnam's. Sustaining gains in practice improvement and clinical outcomes will require strategies that include ongoing engagement with policymakers and other stakeholders at the national and local level, and planning for adaptations and subsequent resource allocations in order to meet the World Health Organization's goals promoting access to effective treatment for all tobacco users.

Trial Registration: NCT02564653 , registered September 2015.
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http://dx.doi.org/10.1186/s13012-020-01035-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488010PMC
September 2020

Relationship between family functioning and health-related quality of life among methadone maintenance patients: a Bayesian approach.

Qual Life Res 2020 Dec 6;29(12):3333-3342. Epub 2020 Aug 6.

Hanoi University of Public Health, Hanoi, Vietnam.

Purpose: To examine the relationship of family functioning on health-related quality of life (HRQoL) among methadone maintenance patients using the Bayesian approach.

Methods: A cross-sectional study was conducted on 182 patients at Go Vap Methadone Clinic, Ho Chi Minh City, Vietnam. Family functioning and HRQoL were measured by the APGAR scale and World Health Organization Quality of Life short-form instrument (WHOQoL-BREF), respectively. Directed Acyclic Graphs were used to present the conceptual framework and to identify a set of confounders of the relationship between family functioning and HRQoL. Bayesian multivariable linear regressions were fitted with four different priors to determine the effect size of the relationship of interest.

Results: The mean score of APGAR was 6.0 (SD = 3.3), and the mean scores of HRQoL were from 47.1 (SD = 17.6) in the social relationships dimension to 69.0 (SD = 10.3) in the environment dimension. Patients with a higher score of family functioning were likely to have a higher score of HRQoL, with coefficients and 95% highest density interval (HDI) greater than 0 in all priors. Family functioning had the most substantial impact on the psychological health dimension, with 99.9% to 100% and 44.6% to 83.7% of posterior distribution greater than 1 and 2, in different priors, respectively.

Conclusion: Family functioning is intimately associated with HRQoL. Treatment plans for patients undergoing methadone maintenance treatment should aim to involve the families appropriately and effectively to maximize the benefits for patients and improve their overall well-being.
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http://dx.doi.org/10.1007/s11136-020-02598-zDOI Listing
December 2020

The Utilization of Maternal Healthcare Services Among Ethnic Minority Populations in Vietnam.

J Racial Ethn Health Disparities 2021 Jun 5;8(3):723-731. Epub 2020 Aug 5.

Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, Hanoi, Vietnam.

Background: Previous studies have observed lower utilization of maternal healthcare services by ethnic minority groups in Vietnam compared with the majority Kinh community. This study sought to assess the utilization of maternal healthcare service-associated factors within 12 ethnic minority groups.

Method: The cross-sectional study enrolled 996 women from 12 ethnic minority groups in Vietnam in 2019. Women had pregnancy outcomes in the last 5 years. The two variables for maternal healthcare utilization were [1] a minimum of four antenatal contacts and [2] health facility-based delivery. We examined the association of individual characteristics of maternal healthcare services using multilevel modeling. Odds ratios (ORs) and 95% confidence intervals (CIs) were reported.

Results: This nationally representative study found that 34.1% of women from ethnic minority backgrounds had four or more antenatal contacts during pregnancy, ranging from 8.3% in Mong community to 80.2% in Cham An Giang. Most of the women (94.4%) delivered at health facilities. Factors independently correlated with having fewer than four antenatal contacts included being illiterate, early marriage, unemployment, religious affiliation, household economy, and distance to the nearest health facility. Factors significantly associated with home delivery were living in the most disadvantaged areas and having fewer than four antenatal contacts.

Conclusion: Substantial inequity exists in antenatal coverage both within ethnic minority groups and between socio-economic groups. The low coverage of having at least four antenatal contacts and its' correlates with facility-based delivery suggests that the government should focus efforts on increasing the number of antenatal contacts for ethnic minority women.
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http://dx.doi.org/10.1007/s40615-020-00832-5DOI Listing
June 2021

Improvement in Compliance With Smoke-Free Environment Regulations at Hotels and Restaurants in Vietnam After an Administrative Intervention.

Environ Health Insights 2020 7;14:1178630220939927. Epub 2020 Jul 7.

World Health Organization, Hanoi, Vietnam.

Introduction: Vietnam is among the countries with the highest smoking prevalence among male adults, as well as high prevalence of secondhand smoke exposure at indoor places. In many countries, including Vietnam, exposure to tobacco smoking is greatest in restaurants/bars and hotels. This study aims to analyze the compliance of hotels and restaurants to smoke-free environment regulations before and after an intervention.

Methods: Direct observations were done at the receptions, conference rooms, designated smoking areas, restaurants, and lobbies of 140 hotels and the dining rooms, kitchens, and toilets of 160 restaurants before and after an intervention. The intervention was a training course conducted by police officers followed by 3 monthly supervision visits by police officers. Compliance with smoke-free enviornment regulations was observed and assessed to generate a compliance score for each location and overall. Tobit regression was used to examine the relationship between compliance scores and the intervention and other variables such as hotel and restaurant characteristics.

Results: Before the intervention, the highest compliance rates were found for "no tobacco advertisement" and "no cigarette selling" regulations (95%-100%) in almost all sites in hotels and restaurants. The lowest compliance rates were found for "having nonsmoking signs." The rate of compliance with all regulations was only 5% for hotels and 0.06% of restaurants. Improvement after intervention was clearly observed, in the rate of compliance with all regulations by more hotels (15.7%) and overall compliance scores of hotels and restaurants.

Conclusions: The intervention with participation of the police officers proved to be effective in improving compliance with smoke-free regulations. It is recommended to continue this intervention in the same areas as well as to expand the intervention to other areas.
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http://dx.doi.org/10.1177/1178630220939927DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7343365PMC
July 2020

Review of Public Financing for Water, Sanitation, and Hygiene Sectors in Vietnam.

Environ Health Insights 2020 6;14:1178630220938396. Epub 2020 Jul 6.

Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam.

Background: Vietnam declared its national roadmap towards Sustainable Development Goals number 6 by 2030. However, specific supporting programmes and financial means to proceed with the roadmap have not been passed on. Evidence on the financing for water, sanitation, and hygiene (WASH) being allocated or spent has not been well documented in Vietnam. This study aimed to obtain an overview and assessed the public funding across the WASH sector of Vietnam in 3 fiscal years 2016, 2017, and 2018.

Methods: A cross-sectional study was conducted for information about the public financing for WASH at both national and sub-national levels. An activity-based costing approach was applied to determine WASH-related public expenditure. Fourteen focus group discussions with key stakeholders were used to identify the WASH activities and to access financial reports of these relevant institutions. TrackFin methodology was used to assemble the public financing for WASH in Vietnam.

Results: The public expenditure of WASH declined by about 30.7% over the 3 fiscal years, from US $2016 million in 2016 to US $1397 million in 2018. Meanwhile, this expenditure allocated to the poor or mountainous areas increased by 3 folds. The highest proportion of WASH public funding was invested in sanitation through large network systems (59.07% of the total public expenditure), whereas the lowest was in hygiene promotion and handwashing facilities. The domestic budget was still the main source of public financing for WASH services, with 2 largest shares coming from government revenues (47.24%) and repayable loans (20.49%).

Conclusion: The main source of financing for WASH was from the government, yet its public expenditure has been decreased. A refined roadmap with specific steps for a sustainable WASH financing system in Vietnam, particularly to leverage government and private sector resources, is required to ensure no one is left behind.
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http://dx.doi.org/10.1177/1178630220938396DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7338735PMC
July 2020

Vietnam Climate Change and Health Vulnerability and Adaptation Assessment, 2018.

Environ Health Insights 2020 22;14:1178630220924658. Epub 2020 Jun 22.

Vice-Rector, Hanoi University of Public Health, Hanoi, Vietnam.

Background: The Global Climate Risk Index 2020 ranked Vietnam as the sixth country in the world most affected by climate variability and extreme weather events over the period 1999-2018. Sea level rise and extreme weather events are projected to be more severe in coming decades, which, without additional action, will increase the number of people at risk of climate-sensitive diseases, challenging the health system. This article summaries the results of a health vulnerability and adaptation (V&A) assessment conducted in Vietnam as evidences for development of the National Climate Change Health Adaptation Plan to 2030.

Methods: The assessment followed the first 4 steps outlined in the World Health Organization's Guidelines in conducting "Vulnerability and Adaptation Assessments." A framework and list of indicators were developed for semi-quantitative assessment for the period 2013 to 2017. Three sets of indicators were selected to assess the level of (1) exposure to climate change and extreme weather events, (2) health sensitivity, and (3) adaptation capacity. The indicators were rated and analyzed using a scoring system from 1 to 5.

Results: The results showed that climate-sensitive diseases were common, including dengue fever, diarrheal, influenza, etc, with large burdens of disease that are projected to increase. From 2013 to 2017, the level of "exposure" to climate change-related hazards of the health sector was "high" to "very high," with an average score from 3.5 to 4.4 (out of 5.0). For "health sensitivity," the scores decreased from 3.8 in 2013 to 3.5 in 2017, making the overall rating as "high." For "adaptive capacity," the scores were from 4.0 to 4.1, which meant adaptive capacity was "very low." The overall V&A rating in 2013 was "very high risk" (score 4.1) and "high risk" with scores of 3.8 in 2014 and 3.7 in 2015 to 2017.

Conclusions: Adaptation actions of the health sector are urgently needed to reduce the vulnerability to climate change in coming decades. Eight adaptation solutions, among recommendations of V&A assessment, were adopted in the National Health Climate Change Adaptation Plan.
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http://dx.doi.org/10.1177/1178630220924658DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7309337PMC
June 2020

Describing the pattern of the COVID-19 epidemic in Vietnam.

Glob Health Action 2020 12;13(1):1776526

Center for Population Health Sciences, Hanoi University of Public Health , Hanoi, Vietnam.

Given the rapid spread of the COVID-19 pandemic and the huge negative impacts it is causing, researching on COVID-19-related issues is very important for designing proactive and comprehensive public health interventions to fight against the pandemic. We describe the characteristics of COVID-19 patients detected in the two phases of the epidemic in Vietnam. Data used in this paper were mainly obtained from the official database of the Ministry of Health of Vietnam. Descriptive statistics were carried out using Stata 16 software. As of 18 May 2020, the cumulative number of COVID-19 cases detected in Vietnam was 324, 16 cases from 4 cities and provinces in the first phase (during 20 days, 0.8 cases detected per day) and 308 cases from 35 cities, provinces in the second phase (during 76 days, 4.1 cases detected per day). Vietnam has mobilized its entire political system to fight the COVID-19 and achieved some initial successes. We found both similarities and differences between the two phases of the COVID-19 epidemic in Vietnam. We demonstrated that the situation of the COVID-19 epidemic in Vietnam is getting more complicated and unpredictable.
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http://dx.doi.org/10.1080/16549716.2020.1776526DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7480474PMC
December 2020

Breast Cancer messaging in Vietnam: an online media content analysis.

BMC Public Health 2020 Jun 19;20(1):966. Epub 2020 Jun 19.

Hanoi University of Public Health, Hanoi, Vietnam.

Background: Breast cancer incidence is increasing in Vietnam with studies indicating low levels of knowledge and awareness and late presentation. While there is a growing body of literature on challenges faced by women in accessing breast cancer services, and for delivering care, no studies have sought to analyse breast cancer messaging in the Vietnamese popular media. The aim of this study was to investigate and understand the content of messages concerning breast cancer in online Vietnamese newspapers in order to inform future health promotional content.

Methods: This study describes a mixed-methods media content analysis that counted and ranked frequencies for media content (article text, themes and images) related to breast cancer in six Vietnamese online news publications over a twelve month period.

Results: Media content (n = 129 articles & n = 237 images) sampled showed that although information is largely accurate, there is a marked lack of stories about Vietnamese women's personal experiences. Such stories could help bridge the gap between what information about breast cancer is presented in the Vietnamese media, and what women in Vietnam understand about breast cancer risk factors, symptoms, screening and treatment.

Conclusions: Given findings from other studies indicating low levels of knowledge and women with breast cancer experiencing stigma and prejudice, more nuanced and in-depth narrative-focused messaging may be required.
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http://dx.doi.org/10.1186/s12889-020-09092-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7304170PMC
June 2020

Perceptions About Mindfulness and Text Messaging for Smoking Cessation in Vietnam: Results From a Qualitative Study.

JMIR Mhealth Uhealth 2020 06 24;8(6):e17337. Epub 2020 Jun 24.

School of Public Health, Georgia State University, Atlanta, GA, United States.

Background: With 15.6 million smokers, Vietnam is one of the top 10 largest cigarette-consuming countries in the world. Unfortunately, smoking cessation programs are still scarce in Vietnam. Mindfulness-based and text messaging-based interventions have been increasingly used in smoking cessation studies in developed countries, with promising results. Given the exponential growth of mobile phone usage in Vietnam in recent years, mobile health interventions could be a potential strategy to increase smoking cessation in Vietnam. However, substantial cultural adaptations are needed to optimize the effectiveness of these interventions among Vietnamese smokers.

Objective: This study aims to involve qualitative research to inform the development of a mindfulness-based text messaging smoking cessation intervention for Vietnamese smokers.

Methods: A total of 10 focus groups were conducted with 71 Vietnamese male smokers aged between 18 and 65 years (5-9 participants per focus group). Overall, 5 focus groups were conducted with smokers who had the intention to quit (ie, preparation stage of change in the transtheoretical model), and 5 focus groups were conducted with smokers who did not have the intention to quit (contemplation or precontemplation stage). The focus groups were audio recorded, transcribed verbatim, and analyzed using NVivo 12 software (QSR International).

Results: The major themes included smoking triggers, barriers and facilitators for quitting, the perceptions of text messaging and mindfulness approaches for smoking cessation, and suggestions for the development of a text messaging-based smoking cessation program. Common smoking triggers included stress, difficulties concentrating, and fatigue. Frequently encountering other people who were smoking was a common barrier to quitting. However, participants indicated that concerns about the harmful effects of smoking on themselves and their wives and children, and encouragement from family members could motivate them to quit. The participants preferred diverse message content, including information about the consequences of smoking, encouragement to quit, and tips to cope with cravings. They suggested that text messages be clear and concise and use familiar language. Most smokers perceived that mindfulness training could be useful for smoking cessation. However, some suggested that videos or in-person training may also be needed to supplement teaching mindfulness through text messages.

Conclusions: This study provides important insights to inform the development of a text messaging-based smoking cessation program that incorporates mindfulness for Vietnamese male smokers. The results could also be useful for informing similar programs in other low- and middle-income countries.
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http://dx.doi.org/10.2196/17337DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7381024PMC
June 2020

Adverse influence of multilevel socioeconomic status on physical activity: results from a national survey in Vietnam.

BMC Public Health 2020 Apr 25;20(1):561. Epub 2020 Apr 25.

Hanoi University of Public Health, No. 1A Duc Thang Ward, North Tu Liem, Ha Noi, Viet Nam.

Background: This study aims to explore associations of individual- and provincial-level socioeconomic status (SES) and the combined interaction among these SES with individual physical activity (PA).

Method: This analyze used data of 3068 Vietnamese people aged 18-65 years from the national representative STEPS survey in 2015 (STEPS2015). The survey collected PA-related data using the Global PA Questionnaire Version 2 and those on provicial-level characteristics from two surveys in 2014, namely the Intercensal Population and Housing Survey (IPHS) and The Vietnam Household Living Standard Survey (VLSS2014). Multilevel linear analyze was performed with individual and provincial characteristics as independent variables and the metabolic equivalent (MET) score - the indicator of individual PA - as the dependent variable.

Results: Male and female participants with insufficient PA accounted for 20.2 and 35.7%, respectively. Both individual- and provicial-level SES were inversely associated with the individual PA level. As the provincial-level monthly income increased by 1 million Vietnam Dongs, the total PA score of individuals residing in that province reduced by 1900 METS. A buffering effect was reported between provincial and individual SES, as the provincial average income increased, the differences in PA scores between different SES groups decreased.

Conclusion: Our data suggest that Vietnamese individuals in low SES groups tended to be more physically active than those in high SES groups because their PA was largely related to work.
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http://dx.doi.org/10.1186/s12889-020-08695-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7183671PMC
April 2020

Proactive and Comprehensive Community Health Actions to Fight the COVID-19 Epidemic: Initial Lessons from Vietnam.

Authors:
Hoang Van Minh

J Rural Health 2021 01 28;37(1):148. Epub 2020 Jun 28.

Hanoi University of Public Health, Hanoi, Viet Nam.

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http://dx.doi.org/10.1111/jrh.12430DOI Listing
January 2021

Experiences of accessing and using breast cancer services in Vietnam: a descriptive qualitative study.

BMJ Open 2020 03 24;10(3):e035173. Epub 2020 Mar 24.

Centre for Public Health, Queen's University Belfast, Belfast, UK.

Objectives: To understand, describe and analyse the experiences of women with breast cancer in Vietnam when accessing and using breast cancer services.

Design: Descriptive qualitative study. Women were interviewed about their experiences from the first time they became aware of symptoms or changes to their body through treatment and post-treatment. This study is the first descriptive study on breast cancer in Vietnam from the perspective of women with a breast cancer diagnosis.

Participants: Women (n=13) who had completed or were still receiving treatment for breast cancer, purposively recruited from the north and south of Vietnam.

Results: An analysis of the experiences of women with breast cancer in Vietnam revealed a lack of awareness and knowledge about breast cancer and symptoms. Family and social support were described as key factors influencing whether a woman accesses and uses breast cancer services. Cost of treatment and out-of-pocket expenditures limited access to services and resulted in significant financial challenges for women and their families.

Conclusions: Vietnam has made huge strides in improving cancer care, and is tackling a complex and expanding public health challenge, however, there are a number of areas requiring strengthening and future research. While Vietnam has successfully expanded social health insurance coverage, changes that increase the percentage of costs covered for specific treatments, such as chemotherapy or radiotherapy, could benefit women and their families.
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http://dx.doi.org/10.1136/bmjopen-2019-035173DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202702PMC
March 2020

Maternal, neonatal, and child health systems under rapid urbanization: a qualitative study in a suburban district in Vietnam.

BMC Health Serv Res 2020 Feb 5;20(1):90. Epub 2020 Feb 5.

JW LEE Center for Global Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.

Background: Vietnam has been successful in increasing access to maternal, neonatal, and child health (MNCH) services during last decades; however, little is known about whether the primary MNCH service utilization has been properly utilized under the recent rapid urbanization. We aimed to examine current MNCH service utilization patterns at a district level.

Methods: The study was conducted qualitatively in a rural district named Quốc Oai. Women who gave a birth within a year and medical staff at various levels participated through 43 individual in-depth interviews and 3 focus group interviews.

Results: Primary MNCH services were underutilized due to a failure to meet increased quality needs. Most of the mothers preferred private clinics for antenatal care and the district hospital for delivery due to the better service quality of these facilities compared to that of the commune health stations (CHSs). Mothers had few sociocultural barriers to acquiring service information or utilizing services based on their improved standard of living. A financial burden for some services, including caesarian section, still existed for uninsured mothers, while their insured counterparts had relatively few difficulties.

Conclusions: For the improved macro-efficiency of MNCH systems, the government needs to rearrange human resources and/or merge some CHSs to achieve economies of scale and align with service volume distribution across the different levels.
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http://dx.doi.org/10.1186/s12913-019-4874-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7003413PMC
February 2020

Patterns of Raised Blood Pressure in Vietnam: Findings from the WHO STEPS Survey 2015.

Int J Hypertens 2019 1;2019:1219783. Epub 2019 Dec 1.

Division of Non-Communicable Diseases, General Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam.

This study aims to describe the prevalence of raised blood pressure and the situation of management for raised blood pressure among the adult population in Vietnam. It also aims to examine the association between diversified socioeconomic and behavioral factors of raised blood pressure and awareness of raised blood pressure. Data were obtained from the STEPS survey conducted in Vietnam in 2015. Survey sample was nationally representative with a total of 3,856 people aged 18-69 years old. The study outcomes included raised blood pressure and awareness of and control of raised blood pressure. Multiple logistic regression was used to examine the association of socioeconomic and behavior risk factors with the outcome variables. The overall prevalence of raised blood pressure in Vietnam in 2015 was 18.9% (95% CI: 17.4%-20.6%). The prevalence of raised blood pressure was higher among men. Significantly correlated factors with raised blood pressure were age, sex, body mass index, and diabetes status. Levels of awareness of raised blood pressure were higher among the older age group and overweight people and lower among ethnic minority groups. Raised blood pressure in Vietnam is a serious problem due to its magnitude and the unacceptably high unawareness rate in the population. Public health actions dealing with the problems of raised blood pressure are urgent, while taking into account its relationship with sex and socioeconomic status. It is clear that the interventions should address all people in society, with a focus on disadvantaged groups which are the rural and ethnic minority peoples.
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http://dx.doi.org/10.1155/2019/1219783DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6913158PMC
December 2019

Meta-analysis of average costs of HIV testing and counselling and voluntary medical male circumcision across thirteen countries.

Afr J AIDS Res 2019 Dec;18(4):341-349

Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico.

Explore facility-level average costs per client of HIV testing and counselling (HTC) and voluntary medical male circumcision (VMMC) services in 13 countries. Through a literature search we identified studies that reported facility-level costs of HTC or VMMC programmes. We requested the primary data from authors and standardised the disparate data sources to make them comparable. We then conducted descriptive statistics and a meta-analysis to assess the cost variation among facilities. All costs were converted to 2017 US dollars ($). We gathered data from 14 studies across 13 countries and 772 facilities (552 HTC, 220 VMMC). The weighted average unit cost per client served was $15 (95% CI 12, 18) for HTC and $59 (95% CI 45, 74) for VMMC. On average, 38% of the mean unit cost for HTC corresponded to recurrent costs, 56% to personnel costs, and 6% to capital costs. For VMMC, 41% of the average unit cost corresponded to recurrent costs, 55% to personnel costs, and 4% to capital costs. We observed unit cost variation within and between countries, and lower costs in higher scale categories in all interventions.
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http://dx.doi.org/10.2989/16085906.2019.1679850DOI Listing
December 2019

Feasibility assessment of invigorating grassrooTs primary healthcare for prevention and management of cardiometabolic diseases in resource-limited settings in China, Kenya, Nepal, Vietnam (the FAITH study): rationale and design.

Glob Health Res Policy 2019 12;4:33. Epub 2019 Nov 12.

1Global Health Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan, 215316 Jiangsu China.

Background: Cardiometabolic diseases are the leading cause of death and disability in many low- and middle-income countries. As the already severe burden from these conditions continues to increase in low- and middle-income countries, cardiometabolic diseases introduce new and salient public health challenges to primary health care systems. In this mixed-method study, we aim to assess the capacity of grassroots primary health care facilities to deliver essential services for the prevention and control of cardiometabolic diseases. Built on this information, our goal is to propose evidence-based recommendations to promote a stronger primary health care system in resource-limited settings.

Methods: The study will be conducted in resource-limited settings in China, Kenya, Nepal, and Vietnam using a mixed-method approach that incorporates a literature review, surveys, and in-depth interviews. The literature, statistics, and document review will extract secondary data on the burden of cardiometabolic diseases in each country, the existing policies and interventions related to strengthening primary health care services, and improving care related to non-communicable disease prevention and control. We will also conduct primary data collection. In each country, ten grassroots primary health care facilities across representative urban-rural regions will be selected. Health care professionals and patients recruited from these facilities will be invited to participate in the facility assessment questionnaire and patients' survey. Stakeholders - including patients, health care professionals, policymakers at the local, regional, and national levels, and local authorities - will be invited to participate in in-depth interviews. A standard protocol will be designed to allow for adaption and localization in data collection instruments and procedures within each country.

Discussion: With a special focus on the capacity of primary health care facilities in resource-limited settings in low- and middle-income countries, this study has the potential to add new evidence for policymakers and academia by identifying the most common and significant barriers primary health care services face in managing and preventing cardiometabolic diseases. With these findings, we will generate evidence-based recommendations on potential strategies that are feasible for resource-limited settings in combating the increasing challenges of cardiometabolic diseases.
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http://dx.doi.org/10.1186/s41256-019-0124-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6849318PMC
November 2019

The cost of implementing Vietnam's national plan of action for nutrition for 2017-2020.

AIMS Public Health 2019 20;6(3):276-290. Epub 2019 Aug 20.

UNICEF Viet Nam, Hanoi, Vietnam.

Background: There is an urgent need to carry out a costing exercise of the National Plan of Action for Nutrition (NPAN) 2017-2020 since the costing of nutrition-sensitive interventions was not entirely integrated and proved difficult to track the different sectors' contributions to the nutrition program.

Objective: To estimate the required budget for the activities of the NPAN in 2017-2020.

Methods: A standard ingredients approach activity-based costing was employed from the provider perspective.

Results: The budget amount required for the NPAN activities in 2017, 2018, 2019 and 2020 would be US$ million 269.0; 310.5; 350.2 and 378.1, respectively. State budgets (especially from Ministry of Health) would be the main funding source for the NPAN. The budget required for implementing nutrition-sensitive interventions would be the largest share (more than 90%) while less than 10% are required for nutrition-specific interventions. The four interventions requiring the largest budget proportion (in 2020) included 1) Micronutrient supplementation (28.3%); 2) Breastfeeding & complementary feeding (21.9%); 3) Treatment of severe acute malnutrition (15.6%); and 4) Disease prevention and management (13.4%).

Conclusions: Based on the data from Vietnam National Health account and the data on GDP of Vietnam, the total required budget for the Vietnam NPAN 2017 (USD millions 5,082) as shares of the State budget for health, total State (Government) budget, and GDP would be 5.29%, 0.49% and 0.14%, respectively. From the estimation, Vietnam represents the nutrition strategy which prioritized on nutrition-sensitive actions, similar to most of the SUN Movement member countries.
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http://dx.doi.org/10.3934/publichealth.2019.3.276DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6779599PMC
August 2019

Is evidence-informed urban health planning a myth or reality? Lessons from a qualitative assessment in three Asian cities.

Health Policy Plan 2019 Dec;34(10):773-783

University of Leeds, Leeds Institute of Health Sciences, Nuffield Centre for International Health and Development, 10.31b, Worsley Building, Clarendon Way, Leeds LS2 9NL, UK.

City governments are well-positioned to effectively address urban health challenges in the context of rapid urbanization in Asia. They require good quality and timely evidence to inform their planning decisions. In this article, we report our analyses of degree of data-informed urban health planning from three Asian cities: Dhaka, Hanoi and Pokhara. Our theoretical framework stems from conceptualizations of evidence-informed policymaking, health planning and policy analysis, and includes: (1) key actors, (2) approaches to developing and implementing urban health plans, (3) characteristics of the data itself. We collected qualitative data between August 2017 and October 2018 using: in-depth interviews with key actors, document review and observations of planning events. Framework approach guided the data analysis. Health is one of competing priorities with multiple plans being produced within each city, using combinations of top-down, bottom-up and fragmented planning approaches. Mostly data from government information systems are used, which were perceived as good quality though often omits the urban poor and migrants. Key common influences on data use include constrained resources and limitations of current planning approaches, alongside data duplication and limited co-ordination within Dhaka's pluralistic system, limited opportunities for data use in Hanoi and inadequate and incomplete data in Pokhara. City governments have the potential to act as a hub for multi-sectoral planning. Our results highlight the tensions this brings, with health receiving less attention than other sector priorities. A key emerging issue is that data on the most marginalized urban poor and migrants are largely unavailable. Feasible improvements to evidence-informed urban health planning include increasing availability and quality of data particularly on the urban poor, aligning different planning processes, introducing clearer mechanisms for data use, working within the current systemic opportunities and enhancing participation of local communities in urban health planning.
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http://dx.doi.org/10.1093/heapol/czz097DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6913712PMC
December 2019

Scientific Evidence for Cancer Control in Vietnam.

Cancer Control 2019 Jan-Dec;26(1):1073274819866450

Global Health at Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA.

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http://dx.doi.org/10.1177/1073274819866450DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6740048PMC
February 2020