title: Knowledge, attitude and practices: assessing maternal and child health care handbook intervention in Vietnam.
abstract: BACKGROUND
  Maternal and Child Health (MCH) Handbook, an integrated MCH home-based record, was piloted in four provinces of Vietnam (Dien Bien, Hoa Binh, Thanh Hoa and An Giang). The study is aimed at assessing the changes in pregnant women's behavior towards the frequencies of their antenatal care service utilizations and their subsequent breastfeeding practices up to six months of age, through the MCH Handbook intervention. This is because the levels of pregnant women's knowledge, attitude and practices (KAP) towards their antenatal care service utilizations and exclusive breastfeeding practices have been previously neither analyzed nor reported in relation to MCH home-based records in the country.
  
  
  METHODS
  To compare pre-intervention baseline in 2011, post-intervention data were collected in 2013. Structured interviews were conducted with randomly selected 810 mothers of children 6-18 months of age in the four provinces. A focus group discussion among mothers in each of four provinces was conducted.
  
  
  RESULTS
  There was no significant difference in pregnant women's knowledge about the need for ≥3 antenatal care visits between pre- and post-interventions. Yet, the proportion of pregnant women who made ≥3 antenatal care visits in post-intervention was significantly higher than in pre-intervention. Thus, MCH Handbook is likely to have contributed to practicing ≥3 antenatal care visits, by changing their attitude. The proportion of mothers who know the need for exclusive breastfeeding necessary during the initial six months significantly increased between pre- and post-interventions. The proportion of those practicing exclusive breastfeeding significantly increased between pre- and post-interventions, too. Thus, MCH Handbook is likely to have contributed to the increase in both knowledge about and practices of exclusive breastfeeding.
  
  
  CONCLUSIONS
  The results of study imply that MCH Handbook contributed to the increase in pregnant women's practices of ≥3 antenatal care visits and in their knowledge about and practice of exclusive breastfeeding. While there is room for improvement in the level of its data recording, the study confirmed that MCH Handbook plays a catalytic role in ensuring a continuum of maternal, newborn and child care. Note that this study is the first study that attempted to estimate pregnant women's behavioral changes through MCH Handbook intervention in Vietnam.
authors: Human Development Department, Japan International Cooperation Agency (JICA), 3rd floor, Nibancho Center Building, 5-25 Niban-cho, Chiyoda-ku, Tokyo, 102-8012, Japan. aiga.hirotsugu@jica.go.jp.|Department of Global Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, NW, 7th floor, Washington DC, 20052, USA. aiga.hirotsugu@jica.go.jp.
authors: Hirotsugu
authors: H
authors: Aiga
authors: Maternal and Child Health Department, Ministry of Health, 138A Giang Vo, Ba Dinh district, Hanoi, Vietnam. ndvinh_moh@yahoo.com.
authors: Vinh Duc
authors: VD
authors: Nguyen
authors: Sustainable Health Development Center, VietHealth, 16, Block 13B, Trung Yen 11, Cau Giay district, Hanoi, Vietnam. ndcuong64@yahoo.com.
authors: Cuong Dinh
authors: CD
authors: Nguyen
authors: Department of Community Health & Preventive Medicine Network Coordination, National Institute of Hygiene and Epidemiology, 1 Yersin, Hai Ba Trung district, Hanoi, Vietnam. poem@nihe.org.vn.
authors: Tho Thi Thi
authors: TT
authors: Nguyen
authors: Department of Community Health & Preventive Medicine Network Coordination, National Institute of Hygiene and Epidemiology, 1 Yersin, Hai Ba Trung district, Hanoi, Vietnam. halien@nihe.org.vn.
authors: Lien Thi Phuong
authors: LT
authors: Nguyen
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D000067576:Child Health / Q000706:statistics & numerical data*; D005260:Female; D017144:Focus Groups; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D000068097:Maternal Health / Q000706:statistics & numerical data*; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D014744:Vietnam