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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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Endurance is a key term used by women in contemporary Vietnam to characterize the moral persistence that their marital lives demand. Accounting for women's endurance requires, as fieldwork in Hanoi indicates, ethnographic attention to how kinship can be temporally and spatially capricious, exceeding the immediately manifest. The concept of spectral kinship aims to capture these latent aspects of kinship and their groundings in people's imaginative lives. Defining relatedness as an imaginal accomplishment, an analytic of spectral kinship draws attention to aspects of social existence that are neither "real" nor "delusional" yet socially powerful nevertheless. Approaching Vietnamese women's endurance through the lens of spectral kinship highlights the invisible, imaginal efforts that women make to cope with the vulnerabilities and contingencies of kinship, thereby bringing into analysis crucial yet often undervalued forms of gendered kin‐work. [domestic distress, endurance, gender, imaginal, hauntology, kinship, spectrality, Vietnam] [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The article focuses on the contributions made by seven Vietnamese medical anthropologists. Topics discussed include highlights of interviews with these researchers including how unconventional research ideas arise, how unconventional research ideas are received and how research results are received from research to practice.

In this article I explore how a 'belonging' perspective can contribute to anthropological reflections on subjectivity and agency. On the basis of two ethnographic cases from Vietnam, I show how people tend to find their bearings in existentially difficult situations by placing themselves within concrete communities of others. Distinguishing between intersubjective, territorial and political forms of belonging, I discuss anthropological approaches to belonging practices, highlighting the shared analytical assumptions that have underpinned anthropological use of the concept. By placing mutuality and responsiveness at the center of attention, I show that a belonging perspective can help us to think more carefully about the complex ways in which freedom and constraint intertwine in human lives. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

In this article I discuss how anthropological investigations of potentiality can be enriched through a focus on time. The ethnographic basis of my inquiry is research conducted in Hanoi, Vietnam, on the use of sonographic imaging. Drawing on this fieldwork, I pursue two main agendas. The first is ethnographic: I explore how the potentiality of children-to-be was represented by people in Hanoi—by pregnant women, by health-care providers, and by population policy makers—showing how social attention concentrated particularly on the unwanted potential of pregnancies. People's fears that pregnancies might end in disastrous ways were, I show, closely related to Vietnam's history of war. The terror of the Second Indochina War lay not only in past atrocities or in present-day memories and bodily injuries but also in the future that childbearing women lived in relation to. The war was not only behind but also ahead of people. The second agenda I pursue is analytical. On the basis of my ethnographic material from Vietnam, and drawing on the philosophy of Martin Heidegger, I discuss the possible analytical gains of placing "potentiality-for-Being" at the center of anthropological studies. With Heidegger, we may understand human existence as structured through an orientation to the future; seen through this lens, possibility is that through which we realize the givenness of our worlds. [ABSTRACT FROM AUTHOR]

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 HIVinfected 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 lowincome 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. [ABSTRACT FROM AUTHOR]

This article explores the roles played by parents living in Hanoi, Vietnam, in shaping the subjectivities of children who are categorized as physically or intellectually impaired. In an effort to comprehend disability in terms of an active and embodied engagement with the world, I employ a phenomenologically inspired ‘intercorporeal’ perspective as a conceptual alternative to ‘medical’ and ‘social’ models of disability. Through this approach I show how, in northern Vietnam, disability in children brings into question the moral integrity of their parents and how this compels parents to define their children's subjectivities in ways that diminish their personhood. The analysis identifies Buddhist notions of karma, everyday ethics of reciprocity, and party-state discourses of productivity as particularly important forces structuring such social responses to human impairment. Résumé L’article explore le rôle joué par des parents vivants à Hanoï, au Vietnam, dans la formation de la subjectivité d’enfants considérés comme handicapés physiques ou mentaux. En s’efforçant d’appréhender le handicap en termes d’engagement actif et incarné dans le monde, l’auteure adopte un point de vue « intercorporel », d’inspiration phénoménologique, pouvant constituer une alternative conceptuelle aux modèles « médicaux » et « sociaux » du handicap. Par cette approche, elle montre comment, dans le Nord du Vietnam, le handicap des enfants remet en question l’intégrité morale de leurs parents, et comment il oblige ceux-ci à définir la subjectivité de leurs enfants d’une manière qui diminue leur valeur en tant que personne. L’analyse identifie les notions bouddhistes de karma, l’éthique quotidienne de la réciprocité et les discours relatifs à la productivité tenus par l’État-parti comme des forces particulièrement importantes à l’œuvre dans la structuration de ces réponses sociales au handicap humain. [ABSTRACT FROM AUTHOR]

In this article, I explore how prenatal screening is imbricated within state agendas, aspirations, and imaginings in contemporary Vietnam. In an effort to develop new ethnographic tropes for understanding the formation called “the state,” I argue for a phenomenological take that emphasizes its affective and embodied aspects. Seeing the anomalous fetus as a “figure of transversality,” as a critical focus for powerful imaginings and desires, I show how state–society relations in Vietnam are suffused by visceral affectivity and moral engagement. In the realm of reproduction, intense sentiments of anxiety, dread, desire, ambition, and hope tie together the state and its citizens, animating individual aspirations as well as national population policies. [ state, science, technology, population, disability, Vietnam] [ABSTRACT FROM AUTHOR]

Across the world, routine pregnancy care is expanding to include ultrasound imaging and other prenatal diagnostic technologies. Yet, despite their global proliferation, hardly any anthropological research has examined how such technologies are employed outside Euro-America. In this article, I investigate how pregnant women in Vietnam's capital, Hanoi, handle the hard choices that ultrasonographies confront them with when a fetal anomaly is detected and a decision must be made to either maintain or terminate the pregnancy. Whereas research conducted in North America, in consonance with the emphasis on individualism in advanced liberal societies, frames prenatal diagnosis in terms of individual "moral pioneering," I show how Vietnamese women turn the choices they have to make into issues of collectivity, kinship, social belonging, and shared responsibility. The general argument advanced is that a comprehensive understanding of individual reproductive actions and intentions necessarily involves close consideration of local configurations of power, subjectivity, and citizenship. [ABSTRACT FROM AUTHOR]

Objective: The prevalence of type 2 diabetes mellitus (T2DM) in Vietnam has doubled from 3% to 6% over the last decades, with potential consequences for persons with diabetes and their caregivers. This study aimed to assess caregiver burdens and factors associated with caregiver burden. Method: A cross-sectional study was conducted in 2019, using data from 1,241 informal caregivers (ICGs). Caregiver burden was scored from 0–32 using 8 questions from the Zarit Burden Interview (ZBI). Quantile regression analysis was used to identify factors associated with caregiver burden. Results: The median score of the ZBI was 7.0 (Q1-Q3: 2.0–10.0), indicating that the burden among caregiver of persons with T2DM is not high. Quantile regression showed that the higher the monthly income, the lower the burden among caregivers (50% quantile and 75% quantile of burden: -0.004). Lower educational level (25%Q: 4.0, 50%Q; 3.0, 75%Q: 2.16), being a farmer (25%Q: 2.0) and providing care to other people besides the person with T2DM (25%Q: 2.0, 50%Q; 2.54, 75%Q: 1.66) were associated with higher burden on caregivers. Conclusion: The study found that caregivers facing additional life stressors, such as low income or other caregiving responsibilities, reported higher levels of burden. These findings could inform the development of interventions targeted at supporting informal caregivers in rural areas in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

In this article, I present an unpublished letter in which Franz Boas offers what would become his final remarks on the work of Sigmund Freud and the influence of psychoanalysis on anthropology. I explore the intellectual and interpersonal field of early psychoanalytic anthropology, outlining Boas's empirical objections to Freud's "ethnology" (what we might call the letter's manifest content), while exploring the less obvious latent factors underpinning his antipathy toward psychoanalytic thought: the marginalization of the Boasian paradigm at Columbia University, the cultural impact of Freud's "untenable" theories, and most significant, the paradoxical and ambivalent appeal of psychoanalysis among Boas's former students and disciples. I close with a set of reflections on the current relationship between anthropology and psychoanalysis, offering thoughts on the role a cultural psychodynamic approach might play in what Géza Róheim called "the anthropology of the future." [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]