Screening with a limited safety net: post-screening service gaps and inequitable access to child protection in Vietnam

Abstract

Background Violence against children is a population-level public health problem in Vietnam, and schools are increasingly tasked with detecting it; yet detection protects a child only if it leads to services. In an earlier phase of this research, about one-third of Vietnamese adolescents who had experienced physical abuse had told someone, yet only 2.95% had told a formal recipient (a teacher, school counsellor, school social worker, or health worker). The problem therefore lies at the formal output of the system, not in children’s silence. This study maps post-screening service gaps in the national child-protection system and analyzes students’ trust as the mechanism linking those gaps to disclosure and help-seeking, read against the 2025 administrative reform. Methods In a convergent design, we combined a national desk review of the child-protection and mental-health service system with a qualitative study comprising 25 in-depth interviews and 16 focus group discussions with teachers and students in eight lower-secondary schools in Bac Giang province (December 2023–March 2024). The qualitative strand illustrates mechanisms rather than representing the national population. Results The desk review shows that the chain of screening, referral, and support breaks or weakens at each major link, that the only near-universal formal channel is the national child helpline, and that coordination is dispersed across ministries operating different management models. In the interviews, students trusted individuals — mainly peers and friends — more than institutions, and disclosures that went unanswered left institutional trust unreinforced. Because no non-stigmatizing mental-health service existed locally, a referral led only to the stigmatized provincial psychiatric hospital, so students avoided the “mental” label rather than take up help. Conclusion The 2025 reform weakened coordination in the short term but could, if implemented well, embed social-work services within the health system. These findings suggest that screening should be expanded only alongside the services to which children can be referred. To our knowledge, this is the first study to map the post-screening gap in Vietnam and tie it to institutional trust. The findings are relevant to Sustainable Development Goal 3 (good health and well-being) and Goal 10 (reduced inequalities).

The authors' abstract, as published at the source. Frontiers in Public Health, 2026 · DOI ↗