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Gammeltoft TM, Nguyen TA, Dung TK, Thi Dang NA, Phuong Nguyen TM, Nguyen VT, Bygbjerg IC. The pioneers of Vietnam's epidemiological transition: an ethnographic study of pregnant women's experiences of gestational diabetes. Glob Health Action 2024; 17:2341521. [PMID: 38693861 PMCID: PMC11067556 DOI: 10.1080/16549716.2024.2341521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 04/07/2024] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is an abnormal glucose metabolism diagnosed during pregnancy that can have serious adverse consequences for mother and child. GDM is an exceptional health condition, as its management serves not only as treatment but also as prevention, reducing the risk of future diabetes in mother and child. OBJECTIVES This qualitative study aimed to explore how pregnant women experience and respond to GDM, focusing particularly on the role of the family environment in shaping women's experiences. METHODS The research was carried out in Vietnam's Thái Bình province in April-May 2023. We conducted in-depth ethnographic interviews with 21 women with GDM, visiting them in their homes. Our theoretical starting point was phenomenological anthropology, and the data were analysed using a thematic analysis approach. RESULTS At the centre of women's experiences was the contrast between GDM as a biomedical and a social condition. Whereas GDM was biomedically diagnosed and managed in the healthcare system, it was often deemed insignificant or non-existent by family members. This made GDM a biomedically present but socially absent health condition. This paradox posed challenges to women's GDM self-care, placing them in pioneering social positions. CONCLUSIONS The biomedical presence yet social absence of GDM turned women into pioneers at biomedical, digital, epidemiological, and family frontiers. This article calls for appreciation of pregnant women's pioneering roles and for health systems action to involve women and families in the development of GDM policies and programmes at a time of sweeping global health changes.
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Affiliation(s)
- Tine M. Gammeltoft
- Department of Anthropology, University of Copenhagen, København, Denmark
| | - Thi Ai Nguyen
- Department of Health Management & Organization, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Hue, Vietnam
| | - Thi Kim Dung
- Department of Epidemiology, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Hue, Vietnam
| | - Ngoc-Anh Thi Dang
- Department of Environmental Health, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Hue, Vietnam
| | - Thi Minh Phuong Nguyen
- Department of Health Sociology, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Hue, Vietnam
| | - Van Tien Nguyen
- Department of Health Management & Organization, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Hue, Vietnam
| | - Ib C. Bygbjerg
- Department of Public Health, Global Health Section, University of Copenhagen, København, Denmark
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Meyrowitsch DW, Thi Dang NA, Phong TV, Nielsen J, Søndergaard J, Cuong ND, Le Minh H, Vu TKD, Bygbjerg IC, Gammeltoft TM, Thanh ND. The effects of diabetes clubs on peer-support, disclosure of diabetes status, and sources of information regarding diabetes management: results of a pilot-intervention in rural Vietnam. Public Health 2024; 228:171-177. [PMID: 38364677 DOI: 10.1016/j.puhe.2023.12.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 12/13/2023] [Accepted: 12/29/2023] [Indexed: 02/18/2024]
Abstract
OBJECTIVES To measure the effects of diabetes clubs on peer support, disclosure of diabetes status, and the source of information regarding the management of diabetes among persons living with type-2 diabetes (T2D) in rural Vietnam. STUDY DESIGN A pre- and post-pilot intervention study was carried out in Thai Binh Province, Vietnam (n = 222). RESULTS Post-intervention, 57.7 % reported using experiences shared by other persons with T2D during the diabetes club sessions. Compared to pre-intervention, there was an increase in the proportion of persons with T2D who disclosed their diabetes status to friends and/or community members (an increase of 15.3 and 13.8 percentage points, respectively). The proportion of persons who reported gathering their own information regarding diabetes management without any support from others decreased from 15.7 % to 6.3 %. Those who reported a relative inside their home or a relative outside their household as their primary source of T2D-relevant information increased from 10.8 % to 18.6 % and from 2.7 % to 9.5 %, respectively. Persons who mentioned that they did not have a need for further support for their diabetes care increased from 18.5 % to 32.0 %. Specific support regarding diabetes-related knowledge received from family members, friends, and/or community members increased from 27.5 % to 62.2 % CONCLUSIONS: These findings suggest a promising potential for the implementation of diabetes clubs to enhance diabetes-relevant knowledge and the quality of self-management among persons living with T2D diabetes in rural areas of Vietnam.
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Affiliation(s)
- D W Meyrowitsch
- Global Health Section, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1353, Copenhagen K, Denmark.
| | - N-A Thi Dang
- Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Thai Binh City, Thai Binh Province, Viet Nam
| | - T V Phong
- Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Thai Binh City, Thai Binh Province, Viet Nam
| | - J Nielsen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1353, Copenhagen K, Denmark
| | - J Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Denmark
| | - N D Cuong
- Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Thai Binh City, Thai Binh Province, Viet Nam
| | - H Le Minh
- Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Thai Binh City, Thai Binh Province, Viet Nam
| | - T K D Vu
- Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Thai Binh City, Thai Binh Province, Viet Nam
| | - I C Bygbjerg
- Global Health Section, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1353, Copenhagen K, Denmark
| | - T M Gammeltoft
- Department of Anthropology, University of Copenhagen, Øster Farimagsgade 5, DK-1353 Copenhagen K, Denmark
| | - N D Thanh
- Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Thai Binh City, Thai Binh Province, Viet Nam
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Dang NAT, Phong Vu T, M. Gammeltoft T, Christian Bygbjerg I, W. Meyrowitsch D, Søndergaard J. Pre-/-post-analyses of a feasibility study of a peer-based club intervention among people living with type 2 diabetes in Vietnam's rural communities. PLoS One 2023; 18:e0290355. [PMID: 38015901 PMCID: PMC10684024 DOI: 10.1371/journal.pone.0290355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/05/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVES Insufficient self-management is a significant barrier for people with type 2 diabetes (T2D) to achieve glycemic control and consequently reduce the risk of acute and long-term diabetes complications, negatively affecting their quality of life and increasing their risk of diabetes-related death. This pre-post study aimed to evaluate whether a peer-based club intervention might reduce glycated hemoglobin from baseline to post-intervention and enhance self-management among people living with T2D in two rural communities in Vietnam. METHODS A pre-post study was implemented with 222 adults with T2D residing in two rural communities in Vietnam. We used a structured questionnaire, clinical examination, and glycated hemoglobin to evaluate the possible effects of a diabetes club intervention by comparing Glycated Hemoglobin (HbA1c), Body Mass Index (BMI), Blood Pressure (BP), and diabetes-related self-management behaviors at baseline and post-intervention. The data were analyzed using SPSS 20, applying two related sample tests (Wilcoxon and McNemar test) and a paired-sample t-test at a significance level of less than 0.05. RESULTS The findings indicated that after implementation of the intervention, there were no significant statistical differences when comparing pre-and post-intervention levels of the primary outcome HbA1c, but some components of diabetes self-management showed statistically significant improvement. CONCLUSIONS After the peer support intervention in a Vietnamese rural community, there was no significant reduction in the primary outcome proportion of patients having an HbA1c less than 7%, but foot care knowledge and practice had improved. TRIAL REGISTRATION ClinicalTrials.gov NCT05602441.
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Affiliation(s)
- Ngoc-Anh Thi Dang
- Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Tuc Phong Vu
- Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Tine M. Gammeltoft
- Department of Anthropology, University of Copenhagen, Copenhagen K, Denmark
| | - Ib Christian Bygbjerg
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
| | - Dan W. Meyrowitsch
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
| | - Jens Søndergaard
- The Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
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Gammeltoft TM. Silence and Sacrifice: Family Stories of Care and the Limits of Love in Vietnam. Ethnos 2022. [DOI: 10.1080/00141844.2022.2129713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
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Gammeltoft TM, Bùi THD, Vũ TKD, Vũ ĐA, Nguyễn TÁ, Lê MH. Everyday disease diplomacy: an ethnographic study of diabetes self-care in Vietnam. BMC Public Health 2022; 22:828. [PMID: 35468753 PMCID: PMC9040217 DOI: 10.1186/s12889-022-13157-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background Understanding people’s subjective experiences of everyday lives with chronic health conditions such as diabetes is important for appropriate healthcare provisioning and successful self-care. This study explored how individuals with type 2 diabetes in northern Vietnam handle the everyday life work that their disease entails. Methods Detailed ethnographic data from 27 extended case studies conducted in northern Vietnam’s Thái Bình province in 2018–2020 were analyzed. Results The research showed that living with type 2 diabetes in this rural area of Vietnam involves comprehensive everyday life work. This work often includes efforts to downplay the significance of the disease in the attempt to stay mentally balanced and ensure social integration in family and community. Individuals with diabetes balance between disease attentiveness, keeping the disease in focus, and disease discretion, keeping the disease out of focus, mentally and socially. To capture this socio-emotional balancing act, we propose the term “everyday disease diplomacy.” We show how people’s efforts to exercise careful everyday disease diplomacy poses challenges to disease management. Conclusions In northern Vietnam, type 2 diabetes demands daily labour, as people strive to enact appropriate self-care while also seeking to maintain stable social connections to family and community. Health care interventions aiming to enhance diabetes care should therefore combine efforts to improve people’s technical diabetes self-care skills with attention to the lived significance of stable family and community belonging.
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Affiliation(s)
- Tine M Gammeltoft
- Department of Anthropology, University of Copenhagen, Øster Farimagsgade 5, DK-1353, Copenhagen K, Denmark.
| | - Thị Huyền Diệu Bùi
- Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Thai Binh, Thai Binh City, Vietnam
| | - Thị Kim Dung Vũ
- Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Thai Binh, Thai Binh City, Vietnam
| | - Đức Anh Vũ
- Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Thai Binh, Thai Binh City, Vietnam
| | - Thị Ái Nguyễn
- Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Thai Binh, Thai Binh City, Vietnam
| | - Minh Hiếu Lê
- Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Thai Binh, Thai Binh City, Vietnam
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Gammeltoft TM, Huyền Diệu BT, Kim Dung VT, Đức Anh V, Minh Hiếu L, Thị Ái N. Existential vulnerability: an ethnographic study of everyday lives with diabetes in Vietnam. Anthropol Med 2021; 29:271-288. [PMID: 34844468 DOI: 10.1080/13648470.2021.1994334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This article asks: how can the concept of existential vulnerability help us to comprehend the human impact of chronic disease? Across the globe, the prevalence of chronic health conditions is rising dramatically, with wide-ranging consequences for human lives. Taking type II diabetes in northern Vietnam as its ethnographic case, this study explores how chronic health conditions are woven into everyday lives, altering subjectivities and social relations. Applying the notion of existential vulnerability as its analytical prism, the article explores three different dimensions of vulnerability: physical, emotional, and social. The analysis highlights the importance of a focus on social connectedness for comprehending the everyday impact of chronic disease and for the development of health care interventions in this domain.
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Affiliation(s)
- Tine M Gammeltoft
- Department of Anthropology, University of Copenhagen, Copenhagen, Denmark
| | - Bùi Thị Huyền Diệu
- Department of Anthropology, University of Copenhagen, Copenhagen, Denmark.,Thái Bình University of Medicine and Pharmacy, Thái Bình City, Viet Nam
| | - Vũ Thị Kim Dung
- Department of Anthropology, University of Copenhagen, Copenhagen, Denmark.,Thái Bình University of Medicine and Pharmacy, Thái Bình City, Viet Nam
| | - Vũ Đức Anh
- Thái Bình University of Medicine and Pharmacy, Thái Bình City, Viet Nam
| | - Lê Minh Hiếu
- Department of Anthropology, University of Copenhagen, Copenhagen, Denmark.,Thái Bình University of Medicine and Pharmacy, Thái Bình City, Viet Nam
| | - Nguyễn Thị Ái
- Department of Anthropology, University of Copenhagen, Copenhagen, Denmark.,Thái Bình University of Medicine and Pharmacy, Thái Bình City, Viet Nam
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Wesselhoeft R, Madsen FK, Lichtenstein MB, Sibbersen C, Manongi R, Mushi DL, Nguyen HTT, Van TN, Kyhl H, Bilenberg N, Meyrowitsch DW, Gammeltoft TM, Rasch V. Postnatal depressive symptoms display marked similarities across continents. J Affect Disord 2020; 261:58-66. [PMID: 31600588 DOI: 10.1016/j.jad.2019.09.075] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 09/08/2019] [Accepted: 09/30/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Postnatal depressive symptoms measured by the Edinburgh Postnatal Depression Scale (EPDS) are reported to display measurement variance regarding factor structure and the frequency of specific depressive symptoms. However, postnatal depressive symptoms measured by EPDS have not been compared between women representing three continents. METHODS A cross-sectional study including birth cohort samples from Denmark, Vietnam and Tanzania. Women were included during pregnancy at routine care sites. Depressive symptoms were self-reported 40-90 days postpartum using the EPDS. Exploratory and confirmatory factor analyses and generalized additive regression models were performed. RESULTS A total of N = 4,516 participated in the study (Denmark N = 2,069, Vietnam N = 1,278, Tanzania N = 1,169). Factor analyses identified three factors (anhedonia, anxiety and depression) that were almost identical in the three study populations. The only variation between countries was that the item 'self-harm' loaded differently. Women from Tanzania and Denmark were more likely to have an EPDS total score above cut-off 12 (12.6% and 6.4%), compared to women from Vietnam (1.9%) (p<0.001). A low level of education was associated with significantly more depressive symptoms after adjusting for country (p<0.001). LIMITATIONS EPDS data was collected at a later time point in the Danish sample. CONCLUSIONS Postnatal depressive symptoms constitute a three-factor model across cultures including the factors anhedonia, anxiety and depression. The frequency of postnatal depressive symptoms differs between high-, medium-, and low-income countries. However, clinicians should bear in mind that low-educated women worldwide are more likely to experience postnatal depressive symptoms.
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Affiliation(s)
- Rikke Wesselhoeft
- Research Unit of Child and Adolescent Mental Health, Institute for Clinical Research, University of Southern Denmark, Mental Health Services in the Region of Southern Denmark, Odense, Denmark.
| | - Frederikke Kjerulff Madsen
- Research Unit of Gynecology and Obstetrics, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Mia Beck Lichtenstein
- Research Unit for E-mental Health Odense, Mental Health Services in the Region of Southern Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Christian Sibbersen
- Research Unit for E-mental Health Odense, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Rachel Manongi
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Declare L Mushi
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Hanh Thi Thuy Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Toan Ngo Van
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Henriette Kyhl
- Hans Christian Andersen Children's Hospital, University of Southern Denmark and Odense Patient data Explorative Network (OPEN), Odense, Denmark
| | - Niels Bilenberg
- Research Unit of Child and Adolescent Mental Health, Mental Health Services in the Region of Southern Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Dan W Meyrowitsch
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Tine M Gammeltoft
- Department of Anthropology, University of Copenhagen, Copenhagen, Denmark
| | - Vibeke Rasch
- Research Unit of Gynecology and Obstetrics, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Abstract
OBJECTIVES The aim of this study was to understand causes of attendance and non-attendance to a follow-up cervical cancer screening among human papillomavirus (HPV)-positive women. DESIGN Semistructured, individual interviews with HPV-positive women and cervical cancer screening nurses. The interview guide and initial data analysis were guided by existing health behaviour theories. However, as the theories limited the potential of the data material, a grounded theory framework guided the final data analysis. SETTING Interviews were conducted in Dar es Salaam, Tanzania, at Ocean Road Cancer Institute (ORCI) or in the homes of screening clients. PARTICIPANTS 15 interviews were conducted with women who had tested HPV-positive during a patient-initiated screening and been appointed for a follow-up screening 14 months later. Nine women had not attended the follow-up appointment, four had delayed attendance and two had attended on the scheduled date. Further, individual interviews were conducted with the two nurses working at ORCI's screening clinic. RESULTS Perceived benefits for attending a patient-initiated screening include treatment of gynaecological symptoms and prevention of disease. The key perceived benefit of a health provider-initiated follow-up screening is prevention, which is challenged by the circumstance that it is seen by women as having merely potential benefit and therefore can be postponed when competing needs are present. Perceived challenges for screening attendance include emotional costs, in the form of fear of the disease, fear of the gynaecological examination as well as direct and indirect economic costs, such as transportation costs, lost income and waiting time. CONCLUSION Cervical cancer screening is one among many tasks that women living in a low-income setting must attend to. Since health provider-initiated follow-up screening is seen as having only potential benefit, attendance can be postponed when competing needs exist. TRIAL REGISTRATION NUMBER NCT02509702.
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Affiliation(s)
- Ditte Søndergaard Linde
- Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- OPEN, Odense Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Vibeke Rasch
- Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Julius D Mwaiselage
- Department for Cancer Prevention Services, Ocean Road Cancer Institute, Dar es Salaam, Tanzania
| | - Tine M Gammeltoft
- Department of Anthropology, University of Copenhagen, Copenhagen, Denmark
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Affiliation(s)
- Tine M Gammeltoft
- a Department of Anthropology , University of Copenhagen , Copenhagen , Denmark
| | - Pauline Oosterhoff
- b Gender and Sexuality Cluster , Institute of Development Studies , Brighton , United Kingdom
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Thu Hương N, Gammeltoft TM. “A Combination of Imagination and Observation”: Medical Anthropology in Vietnam since the 1990s. American Anthropologist 2018. [DOI: 10.1111/aman.13098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Nhị TT, Hạnh NTT, Gammeltoft TM. Emotional violence and maternal mental health: a qualitative study among women in northern Vietnam. BMC Womens Health 2018; 18:58. [PMID: 29699557 PMCID: PMC5921269 DOI: 10.1186/s12905-018-0553-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 04/17/2018] [Indexed: 11/28/2022]
Abstract
Background Worldwide, intimate partner violence (IPV) during pregnancy is a pressing and prevalent public health problem. Existing research has found close associations between IPV and perinatal mental health, yet little is known about women’s own perceptions of these associations. This study aimed to explore Vietnamese women’s experiences of emotional partner violence and their perceptions of the implications of such violence for their mental health. Methods The data were collected through in-depth interviews with 20 women living in Hanoi, Vietnam who had reported exposure to emotional partner violence and attained high depression scores in a prospective cohort study. Ten women were pregnant and ten had recently given birth. The data were analysed by qualitative content analysis. Results The women described emotional partner violence as a major life stressor. Their accounts pointed to three particularly significant dimensions of emotional violence: being ignored by the husband; being denied support; and being exposed to controlling behaviours. These experiences affected the women’s sense of wellbeing profoundly, causing sadness and distress. The women’s accounts indicated that experiences of emotional violence were significantly shaped by dominant kinship arrangements: practices of patrilocal residence and principles of patrilineal descent tended to aggravate women’s vulnerabilities to partner violence. Conclusions This qualitative study from Vietnam documents close associations between emotional partner violence and perinatal distress, while also pointing to kinship arrangements as particularly significant structural contexts shaping women’s experiences of partner violence. The study findings suggest that effective policies and programs to decrease women’s vulnerability to intimate partner violence must take into account the kinship arrangements that prevail in a given society.
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Affiliation(s)
- Trần Thơ Nhị
- Department of Population, Institute for Preventive Medicine and Public Health, Hanoi Medical University, No.1 Ton That Tung, Khuong Thuong, Dong Da, Hanoi, Vietnam.
| | - Nguyễn Thị Thúy Hạnh
- Department of Population, Institute for Preventive Medicine and Public Health, Hanoi Medical University, No.1 Ton That Tung, Khuong Thuong, Dong Da, Hanoi, Vietnam
| | - Tine M Gammeltoft
- Department of Anthropology, University of Copenhagen, Øster Farimagsgade 5, DK-1353, Copenhagen K, Denmark
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Abstract
In this article I propose the notion of domestic mood as an important concept for mental health research. Drawing on ethnographic fieldwork conducted among women living in Hanoi, Vietnam, I explore the maternal mental health problems that the women reported, focusing particularly on the household tensions and conflicts that made the entry into motherhood a distressful experience. To develop the concept of domestic mood, I draw on Martin Heidegger's work, particularly his claim that human being is always a being-with. Comprehending maternal mental health problems, I argue, requires that we pay attention not only to individual states of mind, but also to the ways that domestic environments shape people's moods. Taking this analytical approach, I show how the mental health states of pregnant women and new mothers in Vietnam were inseparable from their husbands' structural vulnerabilities within kin groups.
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Affiliation(s)
- Tine M Gammeltoft
- a Department of Anthropology , University of Copenhagen , Copenhagen , Denmark
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Navne LE, Svendsen MN, Gammeltoft TM. The Attachment Imperative: Parental Experiences of Relation-making in a Danish Neonatal Intensive Care Unit. Med Anthropol Q 2017; 32:120-137. [PMID: 28872187 DOI: 10.1111/maq.12412] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 07/06/2017] [Accepted: 07/20/2017] [Indexed: 11/29/2022]
Abstract
In this article, we explore how parents establish relations with extremely premature infants whose lives and futures are uncertain. Drawing on ethnographic fieldwork in a Danish Neonatal Intensive Care Unit (NICU), we engage recent discussions of the limits of conventional anthropological thinking on social relations and point to the productive aspects of practices of distance and detachment. We show that while the NICU upholds an imperative of attachment independently of the infant's chances of survival, for parents, attachment is contingent on certain hesitations in relation to their infant. We argue that there are nuances in practices of relationmaking in need of more attention (i.e., the nexus of attachment and detachment). Refraining from touching, holding, and feeding their infants during critical periods, the parents enact detachment as integral to their practices of attachment. Such "cuts" in parent-infant relations become steps on the way to securing the infant's survival and making kin(ship). We conclude that although infants may be articulated as "maybe-lives" by staff, in the NICU as well as in Danish society, the ideal of attachment appears to leave little room for "maybe-parents."
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Affiliation(s)
- Laura E Navne
- Department of Health Services Research, University of Copenhagen
| | - Mette N Svendsen
- Department of Health Services Research, University of Copenhagen
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Abstract
From a historical perspective, selective reproduction is nothing new. Infanticide, abandonment, and selective neglect of children have a long history, and the widespread deployment of sterilization and forced abortion in the twentieth century has been well documented. Yet in recent decades selective reproduction has been placed under the aegis of science and expertise in novel ways. New laboratory and clinical techniques allow for the selective fertilization of gametes, implantation of embryos, or abortion of fetuses. Although they will often overlap with assisted reproductive technologies (ARTs), what we term selective reproductive technologies (SRTs) are of a more specific nature: Rather than aiming to overcome infertility, they are used to prevent or allow the birth of certain kinds of children. This review highlights anthropological research into SRTs in different parts of the world, discussing how selective reproduction engages with issues of long-standing theoretical concern in anthropology, such as politics, kinship, gender, religion, globalization, and inequality.
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Affiliation(s)
- Tine M. Gammeltoft
- Department of Anthropology, University of Copenhagen, 1353 Copenhagen, Denmark;,
| | - Ayo Wahlberg
- Department of Anthropology, University of Copenhagen, 1353 Copenhagen, Denmark;,
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Hạnh NTT, Gammeltoft TM, Rasch V. Number and timing of antenatal HIV testing: evidence from a community-based study in Northern Vietnam. BMC Public Health 2011; 11:183. [PMID: 21439043 PMCID: PMC3078880 DOI: 10.1186/1471-2458-11-183] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Accepted: 03/25/2011] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND HIV testing for pregnant women is an important component for the success of prevention of mother-to-child transmission of HIV (PMTCT). A lack of antenatal HIV testing results in loss of benefits for HIV-infected mothers and their children. However, the provision of unnecessary repeat tests at a very late stage of pregnancy will reduce the beneficial effects of PMTCT and impose unnecessary costs for the individual woman as well as the health system. This study aims to assess the number and timing of antenatal HIV testing in a low-income setting where PMTCT programmes have been scaled up to reach first level health facilities. METHODS A cross-sectional community-based study was conducted among 1108 recently delivered mothers through face-to-face interviews following a structured questionnaire that focused on socio-economic characteristics, experiences of antenatal care and HIV testing. RESULTS The prevalence of women who lacked HIV testing among the study group was 10% while more than half of the women tested had had more than two tests during pregnancy. The following factors were associated with the lack of antenatal HIV test: having two children (aOR 2.1, 95% CI 1.3-3.4), living in a remote rural area (aOR 7.8, 95% CI 3.4-17.8), late antenatal care attendance (aOR 3.6, 95% CI 1.3-10.1) and not being informed about PMTCT at their first antenatal care visits (aOR 7.4, 95% CI 2.6-21.1). Among women who had multiple tests, 80% had the second test after 36 weeks of gestation. Women who had first ANC and first HIV testing at health facilities at primary level were more likely to be tested multiple times (OR 2.9 95% CI 1.9-4.3 and OR = 4.7 95% CI 3.5-6.4), respectively. CONCLUSIONS Not having an HIV test during pregnancy was associated with poor socio-economic characteristics among the women and with not receiving information about PMTCT at the first ANC visit. Multiple testing during pregnancy prevailed; the second tests were often provided at a late stage of gestation.
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Affiliation(s)
- Nguyễn TT Hạnh
- Department of Population, Institute for Preventive Medicine and Public Health, Hanoi Medical University, No.1 Ton That Tung Street, Khuong Thuong, Dong Da, Hanoi, Vietnam
| | - Tine M Gammeltoft
- Department of Anthropology, University of Copenhagen, Øster Farimagsgade 5, DK-1353 Copenhagen K, Denmark
| | - Vibeke Rasch
- Department of International Health, Immunology and Microbiology, Faculty of Health Sciences, University of Copenhagen, Øster Farimagsgade 5, DK-1014 Copenhagen, Denmark
- Department of Obstetrics and Gynaecology, Odense University Hospital, 5000 Odense C, Denmark
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Gammeltoft TM. Childhood disability and parental moral responsibility in northern Vietnam: towards ethnographies of intercorporeality. Journal of the Royal Anthropological Institute 2008. [DOI: 10.1111/j.1467-9655.2008.00533.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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