From Research Evidence to Policy: Mental Health Care in Viet Nam/Des Resultats De Recherche a L'elaboration D'une Politique : Soins De Sante Mentale Au Viet Nam/Influencia De la Investigacion En Las Politicas: La Atencion De Salud Mental En Viet Nam

By Harpham, T.; Tuan, T. | Bulletin of the World Health Organization, August 2006 | Go to article overview

From Research Evidence to Policy: Mental Health Care in Viet Nam/Des Resultats De Recherche a L'elaboration D'une Politique : Soins De Sante Mentale Au Viet Nam/Influencia De la Investigacion En Las Politicas: La Atencion De Salud Mental En Viet Nam


Harpham, T., Tuan, T., Bulletin of the World Health Organization


Background

The implementation of evidence-based policy is being encouraged in all public sectors, including health care, in many developed countries. (1) Although the use of evidence-based practice started in medicine its influence is now being seen in public health, especially in the delivery of health services. It is also influencing health policy more broadly. According to some practitioners: "Clinical practice in many countries is being transformed by evidence-based medicine, and a similar transformation in health systems is desperately needed". (2) In the United Kingdom and other developed countries much attention has been paid to the role evidence can have in improving health policy, but there is little research on the progress of evidence-based policy in developing countries. Additionally, the fields of public health and care for people with mental illness are rarely examined to ascertain the extent of the existence of evidence-based policy.

The theory of evidence-based policy has developed rapidly during the past decade. It is now recognized that the policy process (particularly the nature and role of stakeholders) must be understood (3) and that evidence needs to be credible and useful if it is to influence policy-makers. The policy process is not linear, flowing from problem identification through solution to policy-making, but it is iterative and interactive and involves a wide range of actors. (4) The analytical framework for this paper (5,6) considers four interrelated factors that determine whether evidence is likely to be adopted by policy-makers:

* the political context (the process of developing the policy including the role of civil society and power relations within society)

* the evidence itself (including its relevance, method of communication of the evidence, and its source)

* the links used to influence policy and disseminate evidence (including advocacy coalitions, knowledge communities and other networks)

* the external influences on the policymakers (including donors).

We use this framework to analyse how and whether evidence was used to develop health-care policies for people with mental illness in Viet Nam.

Context, resources and key players

There is little published evidence about the extent and nature of mental health problems in Viet Nam. We briefly consider the evidence for different population groups. Only two prevalence studies of maternal mental health have been published. Fisher et al. found that 33% of women attending general health clinics in Ho Chi Minh City were depressed, and 19% explicitly acknowledged suicidal ideation. (7) These levels were much higher than those found in developed countries (where the level is typically 10-15%) and much higher than Vietnamese clinicians had anticipated: for sampling purposes the clinicians had estimated the prevalence to be 1%. This indicates that although Viet Nam may have a culture that proscribes the discussion of emotions or in which distress is associated with shame or stigma, (8) women were willing to reveal their level of distress to interviewers. Results from a nationwide survey of 2000 mothers of one-year-olds (in both rural and urban areas) found a 20% prevalence of depression or anxiety as measured by an instrument validated in Viet Nam. (9) The same study also measured mental health among children and found that 20% had poor mental health. McKelvey et al. emphasized that mental health services for children in Viet Nam were particularly limited due to the prioritization of other health problems, such as infectious diseases and malnutrition. (10)

A national community-based study of 5584 young people aged 14-25 years found that a quarter reported feeling so sad or helpless that they could no longer engage in their normal activities and they found it difficult to function. (11) This study included a slightly higher percentage of females than males; additionally, as many as 34% of girls from ethnic minority groups reported symptoms of depression. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

From Research Evidence to Policy: Mental Health Care in Viet Nam/Des Resultats De Recherche a L'elaboration D'une Politique : Soins De Sante Mentale Au Viet Nam/Influencia De la Investigacion En Las Politicas: La Atencion De Salud Mental En Viet Nam
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.