title: Trends in inequalities in utilization of reproductive health services from 2000 to 2011 in Vietnam.
abstract: OBJECTIVE
  This study aimed to examine changes in utilization of reproductive health services by wealth status from 2000 to 2011 in Vietnam.
  
  
  METHODS
  Data from the Vietnam Multiple Indicator Cluster Surveys in 2000, 2006, and 2011 were used. The subjects were 550, 1023, and 1363 women, respectively, aged between 15 and 49 years who had given birth in the previous one or two years. The wealth index, a composite measure of a household's ownership of selected assets, materials used for housing construction, and types of water access and sanitation facilities, was used as a measure of wealth status. Main utilization indicators were utilization of antenatal care services, receipt of a tetanus vaccine, receipt of blood pressure measurement, blood examination and urine examination during antenatal care, receipt of HIV testing, skilled birth attendance at delivery, health-facility-based delivery, and cesarean section delivery. Inequalities by wealth index were measured by prevalence ratios, concentration indices, and multivariable adjusted regression coefficients.
  
  
  RESULTS
  Significant increase in overall utilization was observed in all indicators (all p < 0.001). The concentration indices were 0.19 in 2000 and 0.06 in 2011 for antenatal care, 0.10 in 2000 and 0.06 in 2011 for tetanus vaccination, 0.23 in 2000 and 0.08 in 2011 for skilled birth attendance, 0.29 in 2006 and 0.12 in 2011 for blood examination, and 0.18 in 2006 and 0.09 in 2011 for health-facility-based delivery. The multivariable adjusted regression coefficients of reproductive health service utilization by wealth category were 0.06 in 2000 and 0.04 in 2011 for antenatal care, 0.07 in 2000 and 0.05 in 2011 for skilled birth attendance, and 0.07 in 2006 and 0.05 in 2011 for health-facility-based delivery.
  
  
  CONCLUSIONS
  More women utilized reproductive health services in 2011 than in 2000. Inequality by wealth status in utilization of antenatal care, skilled birth attendance, and health-facility-based delivery had been reduced.
authors.affiliation: Department of Global Health Promotion, Division of Public Health, Graduate School of Tokyo Medical and Dental University, Japan ; Department of Pediatrics, Hue University of Medicine and Pharmacy, Vietnam.
authors.forename: Nguyen Huu Chau
authors.initials: NH
authors.lastname: Duc
authors.affiliation: Department of Global Health Promotion, Division of Public Health, Graduate School of Tokyo Medical and Dental University, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: Department of Global Health Promotion, Division of Public Health, Graduate School of Tokyo Medical and Dental University, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kizuki
authors.affiliation: Department of Global Health Promotion, Division of Public Health, Graduate School of Tokyo Medical and Dental University, Japan.
authors.forename: Kaoruko
authors.initials: K
authors.lastname: Seino
authors.affiliation: Department of Global Health Promotion, Division of Public Health, Graduate School of Tokyo Medical and Dental University, Japan.
authors.forename: Mosiur
authors.initials: M
authors.lastname: Rahman
keywords: Vietnam; inequality; reproductive health services