Difficulties in getting treatment for injuries in rural Vietnam

Knowledge about the health-seeking behaviour of injury patients is important for the improvement of community health services. The aims of this study were: (1) to describe the healthcare-seeking behaviour of injury patients; (2) to examine factors associated with injury patients seeking care at health facilities; and (3) to describe the costs of health care for injury patients.

This study took place in Bavi District, northern Vietnam within a longitudinal community surveillance site (FilaBavi). All non-fatal unintentional injuries occurring in a sample of 24,776 people during 2000 were recorded.

The injury questionnaire included information on care-seeking behaviour, severity and consequences of injury. Both univariate and multivariate logistic regression models were used to find associations between sociodemographic factors and utilization of any health services, as well as for each type of health service used, compared with the group who did not use any health services.

Of 24,776 persons living in the study area, 1917 reported 2079 new non-fatal debilitating injuries during the four 3-month periods of observation. Health-seeking behaviour relating to the first 1917 injuries was analysed. Self-treatment was most common (51.7%), even in cases of severe injury. There was low usage of public health services (23.2%) among injury patients. Long distances, poor economic status and residence in difficult geographic areas such as highlands and mountains were barriers for seeking health services. A large proportion of household income was spent on treating injury patients. Poor people spent a greater proportion of their income on health care than the rich, and often used less qualified or untrained private providers.

These results demonstrate the logistical and financial difficulties associated with the treatment of injuries in rural Vietnam. This suggests the need to make public health subsidies available more efficiently and equitably. Whilst this study looked at the situation specifically in the context of injury treatment, it is likely that similar patterns apply in other areas of health care.