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Purpose The studies that explore the impacts of national intellectual capital on informal economy are scant. Moreover, the effect of an external factor such as institutional quality that moderates this relationship has largely been neglected in previous studies. Institutions are considered important pillars to accumulate national intellectual capital and reduce shadow economy. As such, this paper aims to investigate how institutional quality moderates the effects of national intellectual capital on informal economy in 17 Asian countries from 2000 to 2018. Design/methodology/approach This paper uses the generalized method of moments techniques, which allow cross-sectional dependence and slope homogeneity in panel data, to examine the moderating role of institutional quality on the relationship between national intellectual capital and informal economy. Various tests are conducted to ensure the robustness of the findings. Findings Empirical findings from this paper indicate that an increase in national intellectual capital and institutional quality declines the informal economy. Interestingly, better institutional quality aggravates the negative effects of national intellectual capital on reducing the size of informal economy. The author also finds that enhancing international trade and economic growth results in a decrease in the informal economy in Asian countries. Practical implications Empirical findings offer policymakers an indication of the relationships between national intellectual capital, institutional quality and informal economy, pointing out that national intellectual capital and institutional quality should be strengthened to allow Asian countries to limit the informal economy. Originality/value This study provides a conceptual model through which the moderating role of institutional quality on the national intellectual capital–informal economy nexus can be recognized. This approach has thus far not been investigated in the existing literature. To the best of the author’s knowledge, this study makes an original contribution to the empirical of national intellectual capital and informal economy nexus and produces new insights into the fields of the moderating effects of institutional quality on this nexus.

Purpose The purpose of this study is to investigate the impact of government administrative capacity and e-government performance on the citizens’ intention to use e-government services by integrating into the technology acceptance model (TAM). In addition, the study investigates the mediating effect of perceived usefulness in these nexus. Design/methodology/approach A quantitative and cross-sectional approach is used to gather the data from 443 respondents in Vietnam. The squares structural equation modeling is used to access the impact of government administrative capacity and e-government performance on the citizens’ intention to use e-government, the mediating effect of perceived usefulness. Findings The results show that e-government performance, government administrative capacity and perceived usefulness are critical determinants of citizens’ intention. Furthermore, government administrative capacity positively impacts e-government performance. More importantly, perceived usefulness plays a mediating role in these relationships. The results also show that both age and qualification moderate the relationship between perceived usefulness and intention. Practical implications The findings of this study provide valuable evidence and implications. Public officials must enhance the administrative capacity as the determination for the application of e-government. They must demonstrate their commitment to implementing e-government initiatives. Moreover, the government should continually carry out policies to improve e-government performance. Originality/value This study uses the TAM by incorporating government administrative capacity and e-government performance. Evidence about the mechanism linking government administrative capacity and e-government performance to citizens' intention to use e-government is scant. With this stated, this study fills these gaps by pioneering exploring the mediating role of perceived usefulness in these relationships.

PurposeThe purpose of this study is to analyze the relationship between public spending, budget imbalance and underground economy. In addition, this paper investigates how budget imbalance moderates the public spending–underground nexus.Design/methodology/approachBy utilizing a data set spanning from 1995 to 2017 of 35 OECD countries, the study has employed Dynamic Common Correlated Effects (DCCE) approach. The study is also extended to consider the marginal effects of public spending on the underground economy at different degrees of budget imbalance.FindingsThe results indicate that an increase in public spending and budget imbalance contributes to the expansion of underground economy. Interestingly, the effects of public spending on the underground economy will enhance and intensify with a higher budget imbalance level. The results are robust to various specifications and their broader implications are discussed.Practical implicationsGovernments should carefully implement a fiscal policy with a clear understanding that increasing public spending leads to the expansion of informality. Besides, policymakers should enforce supportive policies to boost economic growth, cooperation and cross-border trade to control the size of the underground economy.Originality/valueThis study stresses the role of public spending, budget imbalance on the underground economy in OECD nations. To the best of the author's knowledge, this study pioneers to explore the moderating effect of budget imbalance in the public spending–undergrround nexus.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-09-2022-0645.

The present study proposed a framework in examining the effect of destination image and environmental beliefs on willingness to pay for green hotel (WTP). The purpose of this study is to test these relationships. Additionally, the paper also seeks to establish the role of customer attitude to green hotels as a determinant of the relationships specified in the proposed model. The results supported our overall hypothesis and showed that destination image has the largest direct impact on attitude to green hotel while environmental beliefs have the largest direct effect on willing to pay premium for green hotel. Moreover, attitude to green hotel plays a mediating role between destination image and WTP, environmental beliefs and WTP.

Background Antimicrobial misuse is common in low-income and middle-income countries (LMICs), and this practice is a driver of antibiotic resistance. We compared community-based antibiotic access and use practices across communities in LMICs to identify contextually specific targets for interventions to improve antibiotic use practices. Methods We did quantitative and qualitative assessments of antibiotic access and use in six LMICs across Africa (Mozambique, Ghana, and South Africa) and Asia (Bangladesh, Vietnam, and Thailand) over a 2·5-year study period (July 1, 2016–Dec 31, 2018). We did quantitative assessments of community antibiotic access and use through supplier mapping, customer exit interviews, and household surveys. These quantitative assessments were triangulated with qualitative drug supplier and consumer interviews and discussions. Findings Vietnam and Bangladesh had the largest proportions of non-licensed antibiotic dispensing points. For mild illness, drug stores were the most common point of contact when seeking antibiotics in most countries, except South Africa and Mozambique, where public facilities were most common. Self-medication with antibiotics was found to be widespread in Vietnam (55·2% of antibiotics dispensed without prescription), Bangladesh (45·7%), and Ghana (36·1%), but less so in Mozambique (8·0%), South Africa (1·2%), and Thailand (3·9%). Self-medication was considered to be less time consuming, cheaper, and overall, more convenient than accessing them through health-care facilities. Factors determining where treatment was sought often involved relevant policies, trust in the supplier and the drug, disease severity, and whether the antibiotic was intended for a child. Confusion regarding how to identify oral antibiotics was revealed in both Africa and Asia. Interpretation Contextual complexities and differences between countries with different incomes, policy frameworks, and cultural norms were revealed. These contextual differences render a single strategy inadequate and instead necessitate context-tailored, integrated intervention packages to improve antibiotic use in LMICs as part of global efforts to combat antibiotic resistance. Funding Wellcome Trust and Volkswagen Foundation.

Aim This study assessed the Streptococcus pneumoniae colonisation rate and susceptibility to antibiotics among preschool children in rural Vietnam. Method Nasopharyngeal samples were collected from 546 preschool children aged 6-59 months living in 460 households in the rural BaVi District of Hanoi and their main caregivers completed questionnaires. The samples were cultured, and the Streptococcus pneumoniae colonisation rate and antibiotic susceptibility were investigated. Resistance data from this 2014 study were compared with studies in 1999 and 2007, to identify 15-year trends, together with clinical isolates from a national surveillance system of 16 Vietnamese hospital laboratories established in 2013. Results We found that 221/546 (40%) of the cultures were positive for Streptococcus pneumoniae. The susceptibility rates were trimethoprim-sulphamethoxazole (5%), erythromycin (8%), ciprofloxacin (12%), benzyl-penicillin (35%), tetracycline (49%), cefotaxime (55%), moxifloxacin (99%) and vancomycin (99%). All the susceptibility rates were lower in 2014 than 1999 and 2007, except tetracycline. Multi-drug resistance was 80% in 2014, compared to 60% in 2007 and 31% in 1999. Antibiotics was reported used by 191 (35%) within one month, mainly cephalosporins 86 (45%), amoxycillin/ampicillin 69 (36%) and macrolides 30 (16%). Conclusion Streptococcus pneumoniae showed remarkable high resistance to commonly used antibiotics, including cephalosporins. Multi-drug resistance rose from 31% to 80% during the 15-year study period.

Objectives To review community-level consumption of antibiotics in rural Vietnam, according to the WHO Access, Watch, Reserve (AWaRe) classification of 2019, and identify factors associated with the choice of these antibiotics. Methods In this cross-sectional study, data on antibiotic purchases were collected through a customer exit survey of 20 community antibiotic suppliers in Ba Vi District, Hanoi, between September 2017 and July 2018. Antibiotic consumption was estimated through the number of antibiotic encounters, the number of DDDs supplied and the number of treatment days (DOTs) with antibiotics, and analysed according to the AWaRe classification. The factors associated with watch-group antibiotic supply were identified through multivariable logistic regression analysis. Results In total, there were 1342 antibiotic encounters, with access-group antibiotics supplied in 792 encounters (59.0%), watch-group antibiotics supplied in 527 encounters (39.3%) and not-recommended antibiotics supplied in 23 encounters (1.7%). No reserve-group antibiotics were supplied. In children, the consumption of watch-group antibiotics dominated in all three measures (54.8% of encounters, 53.0% of DOTs and 53.6% of DDDs). Factors associated with a higher likelihood of watch-group antibiotic supply were: private pharmacy (OR, 4.23; 95% CI, 2.8–6.38; P Conclusions High consumption of watch-group antibiotics was observed, especially for use in children. The frequent supply of watch-group antibiotics at private pharmacies reconfirms the need for implementing pharmacy-targeted interventions in Vietnam.

Background A plateau in childhood overweight and obesity has been reported in some developed countries while in almost all developing countries this problem is on the rise. The aim of this paper is to describe the changes in prevalence of overweight and obesity within a cohort of preschool children followed for 3 years, and to estimate and compare the incidences in urban and rural children of Hanoi, Vietnam. Methods A longitudinal study of a cohort of 2677 children aged 3 to 6 years old at the beginning of the study was conducted in urban DodaLab and rural FilaBavi, Hanoi, Vietnam. Overall, 2602 children, 1311 urban and 1291 rural, were followed for 3 years with identical measurements of weight and height in 2013, 2014 and 2016. Standard methods were used to estimate prevalence and incidence as well as confidence intervals. Results During the three-year follow-up, the overall estimated prevalence of overweight increased from 9.1% to 16.7%. For the urban children, the increase was considerably higher. The overall prevalence of obesity decreased from 6.4% to 4.5% with less decrease in the urban children. In the group of children who were overweight and obese at the start of the study, 41.4% and 30.7%, respectively, remained in the same state three years later. The incidence of overweight and obesity during the three years were 12.4% and 2.7%, respectively. Boys were more likely to develop obesity than girls. Conclusions Already in preschool age, the prevalence of overweight is high and it continues to increase with age, especially in the urban area. Prevention and intervention programs need to start at early preschool age and actions in urban areas deserve priority.

BACKGROUND: Staphylococcus aureus is a common human pathogen that can colonise the respiratory tract and cause infection. Here we investigate the risk factors associated with nasopharyngeal carriage of S. aureus (including methicillin-resistant S. aureus [MRSA]) in Vietnam. METHODS: Between February and June 2012, nasal and pharyngeal swabs for S. aureus culture, and demographic and socioeconomic data were taken from 1016 participants in urban and rural northern Vietnam, who were randomly selected from pre-specified age strata. RESULTS: Overall S. aureus prevalence was 303/1016 (29.8%; adjusted for age: 33.8%). Carriage in the main cohort was found to be associated with younger age (≤5 years [OR 3.13, CI 1.62-6.03]; 6-12 [OR 6.87, CI 3.95-11.94]; 13-19 [OR 6.47, CI 3.56-11.74]; 20-29 [OR 4.73, CI 2.40-9.31]; 30-59 [OR 1.74, CI 1.04-2.92); with ≥60 as reference), living in an urban area (OR 1.36, CI 1.01-1.83) and antibiotics use (OR 0.69, CI 0.49-0.96). MRSA was detected in 80/1016 (7.9%). Being aged ≤5 years (OR 4.84, CI 1.47-15.97); 6-12 (OR 10.21, CI 3.54-29.50); 20-29 (OR 4.01, CI 1.09-14.77) and wealth (>3/5 wealth index, OR 1.63 CI 1.01-2.62) were significant risk factors for MRSA carriage. CONCLUSIONS: Nasopharyngeal carriage of S. aureus is present in one-third of the Vietnamese population, and is more prevalent among children. Pharyngeal carriage is more common than nasal carriage. Risk factors for S. aureus (including MRSA) carriage are identified in the community.

International audience; Staphylococcus aureus is an important global health problem worldwide. There is still scarce information on the population structure of S. aureus strains in Asia, where the majority of the world population lives. This study characterized the diversity of S. aureus strains in northern Vietnam through multilocus sequence typing (MLST). Eighty-five carriage isolates from the community and 77 invasive isolates from the clinical setting were selected and tested for meticillin resistance and the presence of Panton-Valentine leukocidin (PVL). MLST was performed on these isolates, of which CC59 (25.4 %), CC188 (17.3 %) and CC45 (16.7 %) were the predominant clonal complexes (CCs). CC59 carriage isolates had significantly lower rates of meticillin-resistant S. aureus (MRSA) than their corresponding clinical group isolates (32 vs 83 %). There were no significant differences in rates of MRSA between carriage isolates and clinical isolates of CC45 and CC188. CC59 carriage isolates were significantly lower in rates of PVL + than CC59 clinical isolates (32 vs 83 %), but the converse was shown in CC45 isolates (14 vs 0 %, respectively). This study revealed vast differences in the molecular epidemiology and population structure of S. aureus in community and clinical settings in Vietnam. Nevertheless, the data underline the spread of virulent and/or resistant strains (MRSA and/or PVL +) in the community, suggesting the necessity for further surveillance to determine the mechanism of transmission of these strains (i.e. MRSA/PVL +) outside clinical settings.

Background : Childhood overweight and obesity is a new and emerging problem in Vietnam. The so far observed prevalence increases have pointed to the need for public health intervention strategies with parents as crucial resources for change. Objective : The aim of this study was to understand mothers’ conceptions of childhood overweight. Design : Four focus group discussions were conducted with a total of 33 mothers of preschool children, 4–6 years old, living in urban and rural districts of Hanoi, Vietnam. The discussions were audio taped and transcribed verbatim. The obtained data were analyzed using the principles of phenomenography. Results : Four main categories with 13 subcategories emerged in the process of analysis. The first category, called ‘Concept of overweight’, contained mothers’ views on childhood overweight. A major concern was the negative aspects of overweight such as impaired social interaction and health problems. The second category, ‘Identification of overweight’, described the ways mothers use to recognize overweight in children: own experience, growth chart, and public or health care system’s information. The third category, ‘Causes of overweight’, showed mothers’ understanding of factors possibly contributing to overweight development: unhealthy food and lifestyle, genetic susceptibility, parent’s lack of knowledge, and limited time to take care of children as well as economic improvement. The fourth category, ‘Management of overweight’, described the ways mothers use to manage a child’s weight problem: control of their food intake, increasing their physical activity, and encouraging their child self-control. However, they find such strategies difficult to implement and their intentions are sometimes challenged by the child’s grandparents. Conclusions : The study gives an understanding of the mothers’ conceptions of four important and practically useful aspects of overweight in children. The findings highlight the roles of media and the health care system in enhancing a social awareness of the problem and the need for prevention. Growth charts need to be used more regularly and consciously in child health care for early detection of children at risk and as a tool for information to parents. When designing intervention programs, the entire extended families, especially grandparents and their roles, need to be considered. Keywords: childhood overweight; mothers’ conceptions; preschool children; qualitative study; Vietnam (Published: 23 March 2016) Citation: Glob Health Action 2016, 9 : 30215 - http://dx.doi.org/10.3402/gha.v9.30215

Background : Childhood obesity may soon be an equally important health threat as undernutrition and infectious diseases. Accurate information about prevalence and risk factors of obesity in children is important for the design of prevention. Objective : The aim of this study was to estimate prevalence of overweight and obesity for preschool children in two Vietnamese areas, one urban and one rural, and to identify risk factors. Design : A cross-sectional study was conducted in urban Dong Da and rural Ba Vi districts, Hanoi, Vietnam. Totally, 2,677 children, 1,364 urban and 1,313 rural, were weighed and measured. Caregivers were interviewed. Background information about children and families was obtained from regular household surveys. Results : The prevalence of overweight and obesity combined were 21.1% (95% CI 18.9–23.3) in the urban area and 7.6% (95% CI 6.2–9.2) in the rural. Multiple logistic regression revealed that at the individual level, in both sites, the risk increased with increased child age. The identified urban risk factors were being a boy, consuming large amounts of food, eating fast, and indoor activity less than 2 hours per day. The rural risk factors were frequent consumption of fatty food. At the family level, significant association was found in rural areas with frequent watching of food advertisements on television. Conclusions : Overweight and obesity are emerging problems in Vietnam, particularly in the urban context. Prevention programs should focus on education about healthy eating habits at early preschool age and need to be tailored separately for urban and rural areas since the risk factors differ. Non-healthy food advertisement needs to be restricted. Keywords: overweight; obesity; preschool children; Vietnam (Published: 8 October 2015) Citation: Glob Health Action 2015, 8 : 28615 - http://dx.doi.org/10.3402/gha.v8.28615

Understanding parents’ feeding control practices and their associations with various factors is useful for prevention of childhood obesity, an emerging problem in low- and middle-income countries. The aim of this paper is to describe the control practices used by parents of preschool children in Vietnam and factors associated with these. Two cross-sectional studies were conducted in urban DodaLab (n = 1364) and rural FilaBavi (n = 1313), Health and Demographic Surveillance Sites (HDSS), Hanoi, Vietnam. For 94.9 % of the children, both parents answered the Child Feeding Questionnaire and additional questions about nutritional practices. Children’s and parents’ weight and height were measured. Simple Pearson correlation coefficients, multiple regression and exploratory factor analysis were used for the statistical analysis. Mothers reported the use of more restriction, pressure to eat and monitoring than the fathers. The measured child’s body mass index (BMI) and the mother’s perception of the child’s weight were negatively associated with pressure to eat and positively associated with monitoring. A positive association was found between restriction and the mother’s perception of the child’s weight. In the rural area, high consumption of fatty food, sweets and snacks was associated with high use of restriction and monitoring. The amount of food consumed was negatively associated with the use of pressure to eat. In the urban area, consumption of fatty food and sweets was positively correlated both with restriction and pressure to eat. Monitoring was negatively associated with consumption of fatty food and snacks and positively with the amount of food. Higher education of the mothers was associated with higher use of monitoring, restriction (in the urban area) and pressure to eat (in the rural area). While feeding practices in Vietnam differed between mothers and fathers and between urban and rural areas, the associations with children’s BMI and socioeconomic factors were weak. This implies that parental roles as well as sociodemographic factors should be considered when designing programs for prevention of childhood overweight and obesity.

Rationale: Health and demographic surveillance sites (HDSSs) are important sources for health planning and policy in many low and middle income countries. Almost all HDSSs are in rural settings. The article aims to present the experiences and some concrete results for the first three years of operation of an urban HDSS in Hanoi, Vietnam, and discuss advantages and disadvantages of conducting health studies in HDSSs. Design, population and sample size: The DodaLab urban HDSS was established in 2007 in three communes at different economic levels in Dong Da district, Hanoi, Vietnam. Demographic, social and economic information about 10,000 households and their 37,000 persons was obtained through household interviews. Quarterly follow-up was initiated to provide information about vital events, birth, death and migration. A new household survey was undertaken in 2009. The existing rural HDSS FilaBavi, started in 1999, with 12,000 households and 52,000 persons, was used as the blueprint. Conclusions: It was possible to establish and run an urban HDSS with experiences from the rural site. The urban and rural contexts are different and demographically, economically and socially complex, but the use of HDSSs can facilitate research beyond very simplified models for comparisons. General statements about external validity of results from the HDSS cannot be made. This issue has to be considered specifically in every situation as an integral part of the research so that the results can be made useful outside the researched HDSS and in performing relevant comparisons.

INTRODUCTION: Community acquired K. pneumoniae pneumonia is still common in Asia and is reportedly associated with alcohol use. Oropharyngeal carriage of K. pneumoniae could potentially play a role in the pathogenesis of K. pneumoniae pneumonia. However, little is known regarding K. pneumoniae oropharyngeal carriage rates and risk factors. This population-based cross-sectional study explores the association of a variety of demographic and socioeconomic factors, as well as alcohol consumption with oropharyngeal carriage of K. pneumoniae in Vietnam. METHODS AND FINDINGS: 1029 subjects were selected randomly from age, sex, and urban and rural strata. An additional 613 adult men from a rural environment were recruited and analyzed separately to determine the effects of alcohol consumption. Demographic, socioeconomic, and oropharyngeal carriage data was acquired for each subject. The overall carriage rate of K. pneumoniae was 14.1% (145/1029, 95% CI 12.0%-16.2%). By stepwise logistic regression, K. pneumoniae carriage was found to be independently associated with age (OR 1.03, 95% CI 1.02-1.04), smoking (OR 1.9, 95% CI 1.3-2.9), rural living location (OR 1.6, 95% CI 1.1-2.4), and level of weekly alcohol consumption (OR 1.7, 95% CI 1.04-2.8). CONCLUSION: Moderate to heavy weekly alcohol consumption, old age, smoking, and living in a rural location are all found to be associated with an increased risk of K. pneumoniae carriage in Vietnamese communities. Whether K. pneumoniae carriage is a risk factor for pneumonia needs to be elucidated.

Background Differences between urban and rural settings can be seen as a very important example of gaps between groups in a population. The aim of this paper is to compare an urban and a rural area regarding child growth during the first two years of life as related to mother’s use of antenatal care (ANC), breastfeeding and reported symptoms of illness. Methods The studies were conducted in two Health and Demographic Surveillance Sites, one rural and one urban in Hanoi, Vietnam. Results We found that children in the urban area grow faster than those in the rural area. There were statistical associations between growth and the education of the mother as well as household resources. There were positive correlations between the number of ANC visits and child growth. We also saw a positive association between growth and early initiation (first hour of life) of breastfeeding but the reported duration of exclusive breastfeeding was not statistically significantly related to growth. Reporting symptoms of illness was negatively correlated to growth, i.e. morbidity is hampering growth. Conclusions All predictors of growth discussed in this article, ANC, breastfeeding and illness, are associated with social and economic conditions. To improve and maintain good conditions for child growth it is important to strengthen education of mothers and household resources particularly in the rural areas. Globalization and urbanization means obvious risks for increasing gaps not least between urban and rural areas. Improvement of the quality of programs for antenatal care, breastfeeding and integrated management of childhood illness are also needed in Vietnam.

Background Since the Doi Moi reform 1986 economic conditions in Vietnam have changed significantly and positive health and health care developments have been observed. International experience shows that improved economic conditions in a country can reduce the risk of perinatal mortality, decrease the risk of low birth weight and increase the mean birth weight in newborns. The Health and Demographic Surveillance Site (HDSS) FilaBavi in Bavi district outside Hanoi city has been operational since 1999. An open cohort of more than 12,000 households (52,000 persons) has been followed primarily with respect to demography, economy and education. The aim of this research is to study trends in birth weight as well as birth and delivery practices over the time period 1999–2010 in FilaBavi in relation to the social and economic development. Methods Information about birth weight, sex, place and method of delivery, mother’s age and education as well as household economy of 10,114 children, born from 1999 to 2010, was obtained from the routine data collection in the HDSS. Results Over the study period the mean birth weight remained at the same level, about 3,100 g, in spite of increased economic resources and technology development. At the individual child level we found associations between birth weight and household economy as well as the education of the mother. Hospital delivery increased from about 35% to 65% and the use of Caesarian section increased from 2.6% to 10.1%. Conclusion During the twelve years studied, household income as well as the use of modern technology increased rapidly. In spite of that, the mean and variation of birth weight did not change systematically. It is suggested that increasing gaps in economic conditions and misallocation of resources, possibly to overuse of technology, are partly responsible.