Understanding the barriers to integrating maternal and mental health at primary health care in Vietnam.

Autor:	Trang DTH; Hanoi University of Public Health, 1A Duc Thang, Bac Tu Liem, Ha Noi 10000, Vietnam., Ha BTT; Hanoi University of Public Health, 1A Duc Thang, Bac Tu Liem, Ha Noi 10000, Vietnam., Vui LT; Hanoi University of Public Health, 1A Duc Thang, Bac Tu Liem, Ha Noi 10000, Vietnam., Chi NTQ; Hanoi University of Public Health, 1A Duc Thang, Bac Tu Liem, Ha Noi 10000, Vietnam., Thi LM; Hanoi University of Public Health, 1A Duc Thang, Bac Tu Liem, Ha Noi 10000, Vietnam., Duong DTT; Hanoi University of Public Health, 1A Duc Thang, Bac Tu Liem, Ha Noi 10000, Vietnam., Hung DT; Hanoi University of Public Health, 1A Duc Thang, Bac Tu Liem, Ha Noi 10000, Vietnam., Cronin de Chavez A; Global Health and Development, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, United Kingdom., Manzano A; School of Sociology and Social Policy, University of Leeds, Leeds LS2 9JT, United Kingdom., Lakin K; Nossal Institute for Global Health Melbourne School of Population and Global Health, The University of Melbourne, Victoria 3010, Australia., Kane S; Nossal Institute for Global Health Melbourne School of Population and Global Health, The University of Melbourne, Victoria 3010, Australia., Mirzoev T; Global Health and Development, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, United Kingdom.
Jazyk:	angličtina
Zdroj:	Health policy and planning [Health Policy Plan] 2024 Jun 03; Vol. 39 (6), pp. 541-551.
DOI:	10.1093/heapol/czae027
Abstrakt:	The prevalence of common perinatal mental disorders in Vietnam ranges from 16.9% to 39.9%, and substantial treatment gaps have been identified at all levels. This paper explores constraints to the integration of maternal and mental health services at the primary healthcare level and the implications for the health system's responsiveness to the needs and expectations of pregnant women with mental health conditions in Vietnam. As part of the RESPONSE project, a three-phase realist evaluation study, we present Phase 1 findings, which employed systematic and scoping literature reviews and qualitative data collection (focus groups and interviews) with key health system actors in Bac Giang province, Vietnam, to understand the barriers to maternal mental healthcare provision, utilization and integration strategies. A four-level framing of the barriers to integrating perinatal mental health services in Vietnam was used in reporting findings, which comprised individual, sociocultural, organizational and structural levels. At the sociocultural and structural levels, these barriers included cultural beliefs about the holistic notion of physical and mental health, stigma towards mental health, biomedical approach to healthcare services, absence of comprehensive mental health policy and a lack of mental health workforce. At the organizational level, there was an absence of clinical guidelines on the integration of mental health in routine antenatal visits, a shortage of staff and poor health facilities. Finally, at the provider level, a lack of knowledge and training on mental health was identified. The integration of mental health into routine antenatal visits at the primary care level has the potential help to reduce stigma towards mental health and improve health system responsiveness by providing services closer to the local level, offering prompt attention, better choice of services and better communication while ensuring privacy and confidentiality of services. This can improve the demand for mental health services and help reduce the delay of care-seeking. (© The Author(s) 2024. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.)
Databáze:	MEDLINE
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