Parent-youth communication and concordance between parents and adolescents on reported engagement in social relationships and sexually intimate behaviors in Hanoi and Khanh Hoa Province, Vietnam

Adolescent sexual and reproductive health and rights for ethnic minority girls in Vietnam

There has been significant progress in improved adolescent sexual and reproductive health and rights (ASRHR) for girls across low- to- middle-income countries (LMICs). However, progress has been uneven, and disparities persistent across and within countries. For example, Vietnam is one of only nine countries to have achieved the 2015 maternal mortality rate (MMR) target of the Millennium Development Goals (MDGs) as a nation, but for some sub-populations, progress has been much slower, and MMR is more than twice that the national average. Ensuring equity is a current focus of the Sustainable Development Goals (SDGs) agenda that seeks to Leave No One Behind. This paper explores some of these inequities and potential drivers for ethnic minority adolescent girls in Vietnam, with a specific focus on the Tay community, the largest ethnic minority group in Vietnam. This paper highlights the challenges to progress, including areas where there is still limited evidence about the range of socio-cultural factors that may determine sexual and reproductive health outcomes for Tay adolescent girls. In the era of the SDGs, Vietnam's national policy platforms and current aid architecture provide a solid basis on which to build research, policy and practice investments that improve the health of adolescent ethnic minority girls in Vietnam.

Family structure and function in relation to adolescent reproductive health in developing countries: A scoping review

AIM

The study purpose was to explore the relationships between family structure and function and adolescent reproductive health in the context of family systems in developing countries.

BACKGROUND

The structures and functions of family are important elements for adolescent reproductive health. However, few studies discuss their relationships with the reproductive health of adolescents.

DESIGN

This study employed a scoping review design.

DATA SOURCES

The search was conducted for literature published from 2010 until 2020 using the electronic databases PubMed, CINAHL, Scopus, and Science Direct sourcing full-text papers in English. Original research papers that focused on family structures, family functions, and adolescent reproductive health were included.

REVIEW METHODS

Data extraction and analysis were completed on all retrieved studies. Content analysis was used for data analysis.

RESULTS

Fifteen articles were included. The nature of the relationship between the family structures and functions on adolescent reproductive health were explained in the categories of (i) family process and life cycle, (ii) family norms and values, (iii) family communication patterns and processes, (iv) family roles and connectedness, and (v) family coaching and guidance.

CONCLUSION

Findings of this study suggest that the relationships between family functions and structures and adolescent reproductive health were explained in multiple constructs. Further studies are needed to examine those constructs on reproductive health in adolescent in developing countries.

Young-parent communication on sexual and reproductive health issues among young female night students in Amhara region, Ethiopia: Community-based cross-sectional study

BACKGROUND

Young is a key stage in rapid biological and psychosocial changes affecting every aspect of the lives and an important time to set the foundation for good health in adulthood. Adolescent-parent communication is a potential path for improving sexual and reproductive health outcomes for adolescents, most of parents did not teach their adolescents about sexual and reproductive health. Even though, some researches have been done on day time students, there is no study conducted focusing on young girls attending night school in Ethiopia.

OBJECTIVE

This study aimed to assess young-parent communication on sexual and reproductive health issues and associated factors among night female students in Amhara Region, Ethiopia, 2018.

METHOD

School based quantitative cross-sectional study was employed in Amhara region among 1640 young female night students from September 15 to November 15/2018. Face-to-face interview-administered questionnaires were used to collect the data. Bi-variable and multi-variable logistic regression model were used. Odds ratio (OR) with 95% confidence interval (CI) were computed to determine the strength of association between predictor and outcome variables. P-values less than 0.05 considered as level of significance.

RESULTS

One hundred ten (37.5%) of the students had communication with their parents on at least two issues of sexual and reproductive health (SRH) issues in the last 6 months. Grade level (adjusted odd ratio (AOR) = 2.61, 95% CI (2.04, 3.34)), marital status (AOR = 1.29, 95% CI (1.03, 1.63), living arrangement (AOR = 1.50(1.13, 2.00)), utilization of youth friendly sexual and reproductive health services (AOR = 1.80, 95% CI (1.41, 2.30)), students ever had sexual intercourse (AOR = 1.50, 95% CI (1.23, 1.96)), Information about sexual and reproductive health services (AOR = 1.45(1.16, 1.80)) were associated young-parents communication on sexual and reproductive health issues.

CONCLUSION

In this study young-parent communications on sexual and reproductive health (SRH) issues was found to be limited. Therefore, teachers, health extension workers, and health professionals should strengthen comprehensive SRH education for students in school, churches, mosques, health facilities and encouraging them to participate in different health clubs in school. Parent should give education for their children sexual and reproductive health during the era of young age.

Adolescent-parent communication on sexual and reproductive health issues and associated factors among secondary school students in Woreta town, Northwest Ethiopia: An institutional based cross sectional study

Background

World Health Organization states adolescents as persons whose age is between 10–19 years. In Ethiopia, sexual and reproductive health problems of adolescents are high. Parent-adolescent communication regarding sexual and reproductive health issues is important to reduce adolescent risky sexual behaviors.

Objective

The goal of the study was to assess adolescent communication on sexual and reproductive health issues with parents and associated factors among secondary school students in Woreta town.

Method

Institutional based cross sectional study was conducted among 360 students from March 25–29/2019. Simple random sampling technique was applied to select study participants. Data was collected by self-administered questionnaire. Data was entered into Epinfo7 and analyzed using SPSS version 23. Descriptive statistics, bivariable and multivariable logistic regression analysis were applied. Odds ratios, 95% confidence intervals and P values were calculated.

Variables having P-value < 0.05 in the multivariable logistic regression analysis were considered as determinant factors for adolescent-parent communication on sexual and reproductive health issues.

Result

A total of 360 school adolescents were involved in the study making 100% response rate. One hundred ten (30.6%) of the students had communication with parents on at least 60% of topics of sexual and reproductive health issues. Being Grade 9 (AOR = 2.3; 95% CI: 1.1–4.4) and grade 10 students (AOR = 2.2; 95% CI: 1.1–4.5), students who were knowledgeable on SRH issues (AOR = 3.6; 95% CI: 1.9–6.5) and students who accepted the benefit of communicating SRH issues with parents (AOR = 5.2, 95% CI: 1.9–13.7) were more likely to communicate on SRH issues.

Conclusion

and Recommendation: Adolescent-parent communication on SRH issues was found to be low. The sexual and reproductive health knowledge of adolescents could be enhanced through participating them in different health clubs in school and outside school.

The necessity of education about reproductive health of female adolescents to mothers in Iran: a qualitative study

OBJECTIVES

Parents are challenged to provide the required information about reproductive issues for their adolescents. The study aims to explain women's perception of the necessity of education about adolescent girls, reproductive health to mothers.

METHODS

This research is a qualitative content analysis. Sampling was performed using purposeful sampling to saturation of data. The study sample included 26 mothers and 14 key informants. To collect data, semi-structured interviewing was used. Data trustworthiness was verified based on Lincoln and Guba's criteria and the data was analyzed using conventional content analysis with MAXQDA10 software.

RESULTS

Four themes and 13 main categories each with some subcategories were extracted in this research. The themes and categories included: "risky social-environmental factors (existence of inappropriate educational resources, a challenge between tradition and modernity in the society, social harms, and educational barriers)", weakness in awareness, attitude, and family relationships (mother's limited awareness, mother's negative attitude, improper interaction between the parents and the adolescent in the family, and lack of discussion about sexual and reproductive matters in the family), problems associated with sexual and reproductive health of adolescent girls (puberty changes, insufficient perception, and understanding of the process of puberty and harms arising from early education), and high-risk behaviors of adolescents and their consequences (the adolescent's maladaptive behaviors and their outcomes).

CONCLUSION

The results of this research necessitate education of adolescent girls' reproductive health to mothers.

Iranian mothers' needs for reproductive health education of their adolescent daughters: a qualitative study

INTRODUCTION

In order to be effective in discussing high-risk sexual behaviors with adolescents, mothers need to be educated about their adolescent daughters' sexual issues. As no detailed and exact knowledge on mothers' educational needs concerning adolescent girls' reproductive health is available, the current study was intended to investigate mothers' educational needs concerning their adolescent daughters' reproductive health.

MATERIALS AND METHODS

This research was a qualitative content analysis. Purposive sampling was performed to the saturation point. The samples included 26 mothers and 14 key informants. Semi-structured interviews were used for data collection. Data authenticity was verified based on Lincoln and Guba's criteria and data analysis was conducted using conventional content analysis with MAXQDA10 software.

FINDINGS

In this study, three themes and 13 main categories, each with a number of subcategories were extracted. The themes and main categories included: "appropriate educational content (reproductive health, sexual health, general health, psychological health, family health, social health and spiritual health)", "characteristics of the educator (communicative skill, cognitive skill and moral competence)", and "effective factors in learning (teaching method, learning conditions and environment, and the learner's readiness)".

CONCLUSIONS

The results demonstrated that mothers need to be informed about sexual, reproductive, general, psychological, family, social and spiritual health in adolescent girls. Consequently, the results can help the healthcare authorities to implement need-based programs and boost the effectiveness of education about adolescent girls' reproductive health for mothers.

Parental Verbal Communication and Sexual Knowledge of Senior Secondary School Students in South East, Nigeria

BACKGROUND

Parental verbal communication may influence the sexual knowledge of senior secondary school students in Enugu State, Nigeria.

METHODS

This study utilized a school based cross-sectional study design and was conducted across the six education zones of Enugu State using three-stage sampling technique. A total of 400 respondents completed the interviewer administered questionnaires on their socio-demographics, sexual knowledge and parents' information on verbal communication skills. Obtainable knowledge scores for sexuality ranged between 0-10; scores of 1-5 were classified as poor and 6-10 as good. Data analysis for the quantitative data was done using IBM SPSS; version 22. Chi square test of statistical significance and multivariate analysis using binary logistic regression were used in the analysis, and the level of significance was set at a p value of less than 0.05.

RESULTS

Out of the 400 respondents, 55.5% were girls. The mean age (SD) of the respondents was 15.9 ± 1.3 years. Although 15.5% and 8.8% of the respondents were very comfortable discussing sexually related matters with their mothers and fathers only 34.8% and 16.0% of mothers and fathers were comfortable discussing such matters with the respondents. Less than half of the respondents (42.5%) had good sexual knowledge. Verbal sexual communication between parents and respondents and age above 16 years were found to be predictors of good sexual knowledge.

CONCLUSIONS

Poor parental verbal communication led to the poor knowledge of sexuality among the respondents. Parents should be encouraged to discuss sexuality matters with their children.

Knowledge, attitude, and practice on and willingness to pay for human papillomavirus vaccine: a cross-sectional study in Hanoi, Vietnam

BACKGROUND

Despite its effectiveness in preventing human papillomavirus (HPV) infection, the rate of uptake of the HPV vaccine is low in Vietnam. This study aimed to investigate barriers related to knowledge-attitude-practice (KAP) about the HPV vaccine and willingness to pay (WTP) for the vaccine among those using services in an urban vaccination clinic in Hanoi, Vietnam.

MATERIALS AND METHODS

A cross-sectional study was conducted in a vaccination clinic of the Institute for Preventive Medicine and Public Health in Hanoi, Vietnam, from March to April 2016. KAP on the HPV vaccine was collected using a structured questionnaire. Double-bounded dichotomous-choice questions with open-ended questions were used to examine the WTP of respondents. Interval regression and stepwise logistic models were used to identify factors associated with WTP and the average amount that people would be willing to pay for the vaccine.

RESULTS

Of 492 vaccination service users, 67.9%, 94.6%, and 12.3% of respondents were aware of the best age for HPV vaccination, its benefits, and the target group for vaccination, respectively. While the majority believed that the HPV vaccine was safe (92.8%) and effective (90.8%), and desired to be vaccinated (71.1%), only 31.8% of users were vaccinated. Most of the respondents were willing to pay for the HPV vaccine (86.6%), and willing to pay an average amount of US$49.3. Those aged 20-29 years and earning more than 22 million VND/month (very rich) were more likely to pay for the HPV vaccine than people aged <20 years and earning <7 million VND/month. Users who had attained more than a high-school education and heard about the HPV vaccine from doctors, nurses, or other health professionals tended to be willing to pay for the vaccine at a lower price than individuals with below secondary-level education and who had not heard about the vaccine from these health professionals.

CONCLUSION

Sexual health education and financial assistance should be imparted alongside the HPV vaccination program.

Parents' knowledge, attitudes, behaviors, and barriers to promoting condom use among their adolescent sons

Human immunodeficiency virus (HIV) is increasing in Thai youth. Consequently, a school-based National Condom Strategy program was launched in 2015 to reduce the rate of HIV and sexually transmitted infections. We conducted in-depth interviews of 31 parents/adoptive guardians of high-school age Thai boys to explore parents' knowledge, attitudes, behaviors, and barriers to promoting condom use and its role in preventing HIV/sexually transmitted infections. A descriptive phenomenological approach and thematic analysis was used. Most participants had knowledge and positive attitudes about condom use. Half disagreed with the National Condom Strategy of placing condom vending machines in schools. More than half did not initiate teaching male youth about condom use until the youth had broached the question or only intended to do so when the youths were older. Barriers included parents' lack of condom experience and knowledge, embarrassment/discomfort when talking about condoms, and belief that youth were not sexually active. Parents are a key factor for supporting condom use in Thailand. This study supports the need for education programs for parents.

'Hu Hong' (bad thing): parental perceptions of teenagers' sexuality in urban Vietnam

Background

Teenagers under 18 years old in Vietnam are considered as minors who usually lack the autonomy to make decisions. They are also sometimes viewed as contributors to social evils including crime, violence and substance use. Moreover, most Vietnamese teenagers have unsafe sex before marriage. The objective of this study is to explore the parental perceptions relating to their teenagers’ sexuality, particularly the social and cultural forces, that may hinder access to sexuality information.

Methods

Guided by a Community Advisory Board (CAB), this qualitative study uses four focus group discussions (FGDs) consisting of 12 mothers and 12 fathers, as well as twelve individual in-depth interviews (IDIs) with a diverse sample of parents of teens in Ho Chi Minh City (HCMC), Vietnam. Content and discourse analysis were conducted, based on Foucauldian concepts.

Results

Four themes emerged: 1) Meanings of sexuality and sexuality education, 2) Early sexual intercourse destroys teenagers’ future, 3) Teenagers are not hu hong (spoil/bad thing), are innocent and virgin, and 4) Policing and controlling of sexual intercourse among teens. Parents did not view their teenage children as sexual beings; those who are sexual are considered hu hong. Parents believed that teens need to be policed and controlled to prevent them from becoming hu hong, particularly girls. Controlling of sexuality information by parents was therefore common in HCMC, but differed by gender and educational levels of parents. For example, fathers more than mothers were not comfortable teaching their teenage children about sex and sexuality. Parents with higher education police their teenage children’s usage of the Internet and social media, while parents with lower education control who can be friends with their teenage children.

Conclusions

Vietnamese parents in general have negative views of sex and sexuality education for their teenage children. Recognizing that many Vietnamese teenagers have unsafe sex before marriage, parents need to change their perceptions and understand the importance of comprehensive sexuality education (CSE), which are included in UNESCO, UNFPA and UNICEF-developed CSE tools.

Consequence-based communication about adolescent romantic experience between parents and adolescents: A qualitative study underpinned by social constructionism

Chinese adolescents are increasingly engaging in romantic experiences and high-risk sexual behaviors within a rapidly-changing cultural and socio-economic context. Parental communication about sexuality has been recognized as protective for adolescents to make informed decisions about sexual practice. In this study, we explored what was discussed about adolescent romantic experience between parents and adolescents in China. Twenty-seven parents and 38 adolescents from a northern-eastern city of China were interviewed. Interviews were transcribed verbatim and thematically analyzed using a social constructionism framework. Four themes were identified: (i) detriments of romantic experience to education and future prospect; (ii) health and sociocultural risks of romantic and sexual engagement; (iii) ways of handling romantic experience; and (iv) marriage and family building. The messages were mainly prohibitive and consequence oriented in nature, and lacked specific romantic and sexual information. These messages reflected sociocultural beliefs in education, sexuality, marriage, and family in China, but did not meet the needs of current adolescents. External support from health professionals, such as nurses, is important for parents and adolescents to improve their sexual knowledge and communication skills.

Smoking Initiation and Cessation among Youths in Vietnam: A Longitudinal Study Using the Chi Linh Demographic-Epidemiological Surveillance System (CHILILAB DESS)

Study of smoking initiation and cessation is particularly important in adolescent population because smoking prevention and cessation at this time may prevent several health consequences later in life. There is a very limited knowledge about the determinants of smoking initiation and cessation among youths in Vietnam. This limits the development and implementation of appropriately targeted anti-smoking prevention interventions. This study applied pooled data from 3 rounds of a longitudinal survey in the Chi Linh Demographic—Epidemiological Surveillance System (CHILILAB DESS) in a northern province in Vietnam to analyse the determinants of smoking initiation and cessation among youths. The total of youths in the first round, second, and third rounds was 12,406, 10,211, and 7,654, respectively. The random-effects logit model controlling for both time-variant and time-invariant variables was conducted to explore the associated factors with new smokers and quitters. We found an increase trend of new smokers (7.0% to 9.6%) and quitters (27.5% to 31.4%) during 2009–2013. Smoking initiation and cessation are the result of multifactorial influences of demographic and health behaviours and status. Demographic background (older youths, male, unmarried youths, and youths having informal work) and health behaviours and status (youths who had smoking family members and/or smoking close friends, and had harmful drinking) were more likely to initiate smoking and more difficult to quit smoking. Among these variables, youths who had smoking close-friends had the highest likelihood of both initiating smoking and failed quitting. Our results could represent the similar health problems among youths in peri-urban areas in Vietnam. Further, our findings suggested that anti-smoking interventions should involve peer intervention, integrated with the reduction of other unhealthy behaviours such as alcohol consumption, and to focus on adolescents in their very early age (10–14 years old).

Immaturity in puberty and negative attitudes toward reproductive health among Indonesian adolescents

BACKGROUND

Complex factors influence adolescents' attitudes. Secondary sexual development and emotional changes are markers of puberty and affect attitudes toward reproductive health (RH). This is especially evident in the society and culture of Indonesia. This study examined the presence of immaturity at puberty and factors associated with negative attitudes toward RH among Indonesian adolescents.

METHODS

We conducted a cross-sectional study with 1040 students (aged 11-16 years) selected using multistage random cluster sampling. Data were collected using a self-administered questionnaire that included the illustrative questionnaire for interview surveys with young people and the pubertal development scale (PDS), modified in accordance with the Indonesian context. Data analysis used descriptive and comparative statistics and logistic regression analyses.

RESULTS

Immature pubertal development was higher in boys [22.7%, 95% confidence interval (CI): 14.7%-30.7%] than girls (18.4%, 95% CI: 11%-25.7%). However, negative attitudes were higher in girls (40.6%, 95% CI: 34.3%-46.8%) than boys (37.1%, 95% CI: 29.9%-44.7%). Factors associated with negative attitudes toward RH in both boys and girls were age, RH communication with parents, and pubertal development. Smoking was an additional factor in boys, whereas living in an urban area was an additional factor in girls. High knowledge about RH was associated with less negative attitudes toward RH in both boys and girls.

CONCLUSION

Immaturity and factors that influence negative attitudes toward RH should be explored during puberty. Improving knowledge about RH may help to prevent negative attitudes toward RH, especially for girls in urban areas and boys with smoking habits.

FACTORS INFLUENCING UNINTENDED PREGNANCY AND ABORTION AMONG UNMARRIED YOUTH IN VIETNAM: A LITERATURE REVIEW

Unintended pregnancy and abortion among unmarried youths arepublic health issues in Vietnam. This review aims to analyse factors influencing unintended pregnancy and abortion among unmarried youths using published and unpublished literatures. An ecological model was used as the conceptual framework with five levels of factors to guide the analysis. The intrapersonal factors include increasing permissive attitudes and practices of premarital sex, lack of knowledge on contraception, andlow self-efficacy among females. The interpersonal factors include poor communication among partners and between parents and youths on sexuality-related issues, and peer-influence. The organizational factors include inadequate sexuality education and sexual and reproductive health (SRH) services for youths. The contextual factors include gender inequality, cultural norms, and migration. The final level is lack of separate policy on youth SRH. The findings point out four major determinants of unintended pregnancy and abortion among unmarried youths, including: 1) cultural norms, which consider premarital sex is a taboo; 2) lack and inadequate quality of sexuality education in the schools; 3) lack of youth-friendly SRH services; and 4) no separate policy addressing youth SRH.

A quarter century of HIV prevention intervention efforts among children and adolescents across the globe

In 1988 a group of pediatricians, developmental, clinical, child and social psychologists, anthropologists and health educators began researching in Baltimore, Maryland, on an Human Immunodefiency Virus (HIV) prevention intervention, Focus on Youth (FOY). Over the next 25 years, the questions being addressed by FOY reflected those of the global HIV research experience. During the first phase, the questions being addressed by the broader research community included: Can HIV risk behaviors be purposefully impacted by behavioral interventions? If so, how do successful interventions differ from those that are not effective? Are theory-based interventions more likely to be effective than information-only-based interventions? Can theories be translated into culturally and developmentally appropriate interventions including those that are appropriate for children and adolescents? Should parents be involved – and if so, how? During its next phase, the FOY team increasingly became concerned with a disturbing reality. A large number of interventions had been developed and some had been shown to have evidence of impact. But virtually all of these interventions had been conducted in the USA or Europe. The questions facing researchers included: With the global burden of HIV disproportionately impacting low- and middle-income countries (LMIC), especially those in southern Africa, the Caribbean and parts of Asia, what is known about the effectiveness of western-based interventions in these culturally, racially and economically disparate settings? With the exciting proliferation of interventions, federal agencies in the USA and international agencies including Joint United Nations Programme on HIV/AIDS realized the importance of assessing the research portfolio and developing metrics of effectiveness. The questions during this phase included: What is an “effective” intervention? How are effective interventions implemented in a new setting? This phase merged with the next phase as researchers and public health workers realized that the dissemination to a new community of an intervention developed and found to be effective in one community requires change. The central questions during this time included: What changes or kinds of changes can be made to an intervention without undermining its effectiveness? What aspects of an intervention cannot be changed without potentially undermining its effectiveness? What constitutes a “change”? Who should be involved in this decision-making? These efforts culminated in our current phase, one focused on implementation. We must learn more about the factors that allow an intervention to survive and thrive and selectively target these critical factors. The main objective of this paper is to review our experiences and lessons learned in developing, implementing and evaluating FOY in a wide range of socio-cultural settings over the past quarter of century.

Evaluation of three adolescent sexual health programs in ha noi and khanh hoa province, Vietnam

With an increase in sexual activity among young adults in Vietnam and associated risks, there is a need for evidence-based sexual health interventions. This evaluation of three sexual health programs based on the Protection Motivation Theory (PMT) was conducted in 12 communes in Ha Noi, Nha Trang City, and Ninh Hoa District. Inclusion criteria included unmarried youth 15–20 years residing in selected communes. Communes were randomly allocated to an intervention, and participants were randomly selected within each commune. The intervention programs included Vietnamese Focus on Kids (VFOK), the gender-based program Exploring the World of Adolescents (EWA), and EWA plus parental and health provider education (EWA+). Programs were delivered over a ten-week period in the communities by locally trained facilitators. The gender-based EWA program with parental involvement (EWA+) compared to VFOK showed significantly greater increase in knowledge. EWA+ in comparison to VFOK also showed significant decrease at immediate postintervention for intention to have sex. Sustained changes are observed in all three interventions for self-efficacy condom use, self-efficacy abstinence, response efficacy for condoms, extrinsic rewards, and perceived vulnerability for HIV. These findings suggest that theory-based community programs contribute to sustained changes in knowledge and attitudes regarding sexual risk among Vietnamese adolescents.