Ethnic inequity in neonatal survival: a case-referent study in northern Vietnam.
OBJECTIVE
In this study from Quang Ninh province in northern Vietnam (sub-study of the trial Neonatal Health - Knowledge into Practice, NeoKIP, ISRCTN 44599712), we investigated determinants of neonatal mortality through a case-referent design, with special emphasis on socio-economic factors and health system utilization.


METHODS
From July 2008 until December 2009, we included 183 neonatal mortality cases and 599 referents and their mothers were interviewed.


RESULTS
Ethnicity was the main socio-economic determinant for neonatal mortality (OR 2.08, 95% CI 1.39-3.10, adjusted for mothers' education and household economic status). Health system utilization before and at delivery could partly explain the risk elevation, with an increased risk of neonatal mortality for mothers who did not attend antenatal care and who delivered at home (OR 4.79, 95% CI 2.98-7.71). However, even if mothers of an ethnic minority attended antenatal care or delivered at a health facility, the increased risk for this group was sustained.


CONCLUSIONS
Our study demonstrates inequity in neonatal survival that is related to ethnicity rather than family economy or education level of the mother and highlights the need to include the ethnic dimension in the efforts to reduce neonatal mortality.
International Maternal and Child Health (IMCH), Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. mats.malqvist@kbh.uu.se
Mats
M
Målqvist
Nguyen Thu
NT
Nga
Leif
L
Eriksson
Lars
L
Wallin
Dinh Phuong
DP
Hoa
Lars Åke
LÅ
Persson
D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D005260:Female; D054624:Health Status Disparities; D006700:Home Childbirth / Q000706:statistics & numerical data; D006801:Humans; D007226:Infant Mortality / Q000208:ethnology*; D007231:Infant, Newborn; D008297:Male; D008913:Minority Groups / Q000706:statistics & numerical data*; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data; D036301:Qualitative Research; D012307:Risk Factors; D012959:Socioeconomic Factors; D014744:Vietnam / Q000453:epidemiology; D055815:Young Adult