Overuse of Obstetric Ultrasound in Rural, Ethnic Minority Areas of Vietnam
Vietnam has made huge strides in reducing maternal mortality in the past 20 years1 with a 70% reduction in deaths of women during pregnancy and childbirth. Despite Vietnam’s overall progress on maternal health, marginalised ethnic minority communities face lower access to healthcare and higher maternal mortality.
As part of our qualitative research projects aiming to address maternal health inequities among pregnant ethnic minority women in rural Northern Vietnam, we found that ultrasound scans from for-profit clinics were a major part of women’s pregnancy care. Women paid for 8-10 scans during pregnancy at $6.15USD per scan (despite earning only $120-$205USD/month) to access what they considered to be high-quality, good-value, tangible antenatal care. While not a central focus of our research we were curious about the implications of this trend extending to affect rural-dwelling ethnic minority women who face lower education, economic marginalization, and a 4-fold higher maternal mortality rate.
Our findings raise concerns about safety, the exploitation of families’ financial vulnerability, and health policy. There is no evidence that repeated ultrasounds improve maternal health outcomes; on the contrary, it is likely that such overuse could put a strain on limited household resources and distract women and families from evidence-based services. Our research suggests health system gaps, particularly around health promotion, and regulation of the for-profit private sector, are driving poor women towards unnecessary Obstetric ultrasound scans.
Investment in health education, health promotion, and provision of reliable, appropriately-regulated, good-quality maternal healthcare is essential to improving pregnancy outcomes and health equity for ethnic minority communities in Vietnam.
'Improving maternal & child health for ethnic minority women in Vietnam at scale using digital health' is a study being led by Dr. Liem Nguyen (Institute Of Population Health And Development, Hanoi and supported by Professor Sumit Kane (University Of Melbourne), Prof John O'Neill (Simon Fraser University), and Bronwyn McBride a postdoctoral fellow at Simon Fraser University.