Determinants of home, commune health centre and hospital setting for vaginal birth in Vietnamese women

Introduction: Few quantitative studies globally have evaluated determinants for home, health centre and hospital birth separately, despite large differences between the services provided. This study explores the sociodemographic and pregnancy-related determinants of birth-setting in Vietnam (n=1812) for vaginal birth using Young Lives data. Methods: Random sampling obtained 2,000 children (age 6-18months) within four purposively selected regions: Northern Uplands, Red River Delta, Central Coast and Mekong Delta. Multinomial regression modelling explored determinants of use across birth setting: home (reference), health centre and hospital. Results: Women in the study reported hospital delivery (n=813, 45%), followed by health centre (n=563, 31%) and home (n=436, 24%). Women delivering at home were predominately from rural areas (98%), among the poorest women (73%), had no antenatal care (53%) and were multipara (64%). Women who lived in a rural area had lower odds (OR=0.29; 95% CIs 0.13-0.66) of health centre delivery, compared to their urban counterparts, however this was not the case for hospital delivery. Lower wealth decreased the likelihood of hospital delivery (OR=0.46; 95% CI 0.28–0.74), compared to home birth but had no significant effect on health centre delivery. Conclusion: This study found that sociodemographic and pregnancy-related determinants for home birth, health centre and hospital delivery were different for a number of factors in this population, having important implications for policy development.