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Nguyen AD, Nguyen LH, Nguyen LD, Ninh LT, Nguyen HTT, Nguyen CT, Nathan N, Do AL, Le AM, Doan LP, Nguyen SH, Vu TMT, Tran BX, Latkin CA, Ho CSH, Ho RCM. Toward sustainable development goals in gender inequality: an analysis of gender preferences among urban pregnant women in a Southeast Asian country. BMC Pregnancy Childbirth 2023; 23:780. [PMID: 37950212 PMCID: PMC10638686 DOI: 10.1186/s12884-023-06109-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 11/04/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Gender-biased discrimination and preferences are global phenomena, particularly son preferences. However, updated evidence about this issue in Vietnam has not yet been provided. Therefore, this study aimed to examine the gender preferences among pregnant women and identify associated factors of such preferences. METHODS A cross-sectional survey was conducted in two hospitals in Vietnam with 732 pregnant women. Gender preferences for their child were asked, along with socio-demographic (e.g., education, occupation) and pregnancy characteristics (e.g., pressure to have a son, gender of first child, the importance to have a son of family members, and information sources on pregnancy care) by using face-to-face interviews and a structured questionnaire. Multinomial logistic regression was performed to determine factors associated with gender preferences. RESULTS About 51.9% of the participants had no gender preference, while, among those who had a gender preference, 26.5% preferred sons, and 21.6% preferred daughters. Only 6.2% had pressure to have a son. Having the first child who was female (OR = 4.16, 95%CI = 1.54-11.25), having the pressure to have a son (OR = 6.77, 95%CI = 2.06-22.26), and higher self-perceived importance to have a son (OR = 3.05, 95%CI = 1.85-5.02) were positively associated with son preference. Otherwise, women having partners with high school education or above (OR = 2.04, 95%CI = 1.06-3.91), living with parents-in-law (OR = 2.33; 95%CI = 1.25-4.34), the higher number of pregnancies, and a higher degree of importance in having a son regarding parents-in-law (OR = 2.15, 95%CI = 1.38-3.35) associated with higher odds of preferring daughter. CONCLUSION This study showed that gender preference was common among pregnant women, but the pressure to have a son was low. Further education programs and legal institutions should be implemented to improve gender inequality and gender preference in society.
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Affiliation(s)
- Anh Duy Nguyen
- Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam
| | - Long Hoang Nguyen
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Lam Duc Nguyen
- Department of Anesthesiology, Hanoi Medical University, Hanoi, Vietnam
| | - Ly Thi Ninh
- Social Affair Department, Ca Mau Obstetrics & Pediatrics Hospital, Ca Mau, Vietnam
| | | | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, 550000, Vietnam.
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam.
| | - Nila Nathan
- Quantitative Biomedical Sciences, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
| | - Anh Linh Do
- Institute of Health Economics and Technology, Hanoi, Vietnam
| | - Anh Minh Le
- Institute of Health Economics and Technology, Hanoi, Vietnam
| | - Linh Phuong Doan
- Institute for Global Health Innovations, Duy Tan University, Da Nang, 550000, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Son Hoang Nguyen
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, 700000, Vietnam
| | | | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Cyrus S H Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
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Urquia ML, Moineddin R, Jha P, O'Campo PJ, McKenzie K, Glazier RH, Henry DA, Ray JG. Sex ratios at birth after induced abortion. CMAJ 2016; 188:E181-E190. [PMID: 27067818 DOI: 10.1503/cmaj.151074] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2016] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Skewed male:female ratios at birth have been observed among certain immigrant groups. Data on abortion practices that might help to explain these findings are lacking. METHODS We examined 1 220 933 births to women with up to 3 consecutive singleton live births between 1993 and 2012 in Ontario. Records of live births, and induced and spontaneous abortions were linked to Canadian immigration records. We determined associations of male:female infant ratios with maternal birthplace, sex of the previous living sibling(s) and prior spontaneous or induced abortions. RESULTS Male:female infant ratios did not appreciably depart from the normal range among Canadian-born women and most women born outside of Canada, irrespective of the sex of previous children or the characteristics of prior abortions. However, among infants of women who immigrated from India and had previously given birth to 2 girls, the overall male:female ratio was 1.96 (95% confidence interval [CI] 1.75-2.21) for the third live birth. The male:female infant ratio after 2 girls was 1.77 (95% CI 1.26-2.47) times higher if the current birth was preceded by 1 induced abortion, 2.38 (95% CI 1.44-3.94) times higher if preceded by 2 or more induced abortions and 3.88 (95% CI 2.02-7.50) times higher if the induced abortion was performed at 15 weeks or more gestation relative to no preceding abortion. Spontaneous abortions were not associated with male-biased sex ratios in subsequent births. INTERPRETATION High male:female ratios observed among infants born to women who immigrated from India are associated with induced abortions, especially in the second trimester of pregnancy.
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Affiliation(s)
- Marcelo L Urquia
- Centre for Global Health Research (Jha), St. Michael's Hospital; Centre for Research on Inner City Health (Urquia, O'Campo, Glazier), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Departments of Medicine, and Obstetrics and Gynecology (Ray), St. Michael's Hospital; Dalla Lana School of Public Health (Urquia, Jha, O'Campo, Henry), University of Toronto; Department of Family and Community Medicine (Moineddin, Glazier), University of Toronto; Centre for Addiction and Mental Health (McKenzie), University of Toronto; Department of Psychiatry (McKenzie), University of Toronto; Institute for Clinical Evaluative Sciences (Urquia, Moineddin, O'Campo, Glazier, Henry, Ray), Toronto, Ont.
| | - Rahim Moineddin
- Centre for Global Health Research (Jha), St. Michael's Hospital; Centre for Research on Inner City Health (Urquia, O'Campo, Glazier), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Departments of Medicine, and Obstetrics and Gynecology (Ray), St. Michael's Hospital; Dalla Lana School of Public Health (Urquia, Jha, O'Campo, Henry), University of Toronto; Department of Family and Community Medicine (Moineddin, Glazier), University of Toronto; Centre for Addiction and Mental Health (McKenzie), University of Toronto; Department of Psychiatry (McKenzie), University of Toronto; Institute for Clinical Evaluative Sciences (Urquia, Moineddin, O'Campo, Glazier, Henry, Ray), Toronto, Ont
| | - Prabhat Jha
- Centre for Global Health Research (Jha), St. Michael's Hospital; Centre for Research on Inner City Health (Urquia, O'Campo, Glazier), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Departments of Medicine, and Obstetrics and Gynecology (Ray), St. Michael's Hospital; Dalla Lana School of Public Health (Urquia, Jha, O'Campo, Henry), University of Toronto; Department of Family and Community Medicine (Moineddin, Glazier), University of Toronto; Centre for Addiction and Mental Health (McKenzie), University of Toronto; Department of Psychiatry (McKenzie), University of Toronto; Institute for Clinical Evaluative Sciences (Urquia, Moineddin, O'Campo, Glazier, Henry, Ray), Toronto, Ont
| | - Patricia J O'Campo
- Centre for Global Health Research (Jha), St. Michael's Hospital; Centre for Research on Inner City Health (Urquia, O'Campo, Glazier), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Departments of Medicine, and Obstetrics and Gynecology (Ray), St. Michael's Hospital; Dalla Lana School of Public Health (Urquia, Jha, O'Campo, Henry), University of Toronto; Department of Family and Community Medicine (Moineddin, Glazier), University of Toronto; Centre for Addiction and Mental Health (McKenzie), University of Toronto; Department of Psychiatry (McKenzie), University of Toronto; Institute for Clinical Evaluative Sciences (Urquia, Moineddin, O'Campo, Glazier, Henry, Ray), Toronto, Ont
| | - Kwame McKenzie
- Centre for Global Health Research (Jha), St. Michael's Hospital; Centre for Research on Inner City Health (Urquia, O'Campo, Glazier), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Departments of Medicine, and Obstetrics and Gynecology (Ray), St. Michael's Hospital; Dalla Lana School of Public Health (Urquia, Jha, O'Campo, Henry), University of Toronto; Department of Family and Community Medicine (Moineddin, Glazier), University of Toronto; Centre for Addiction and Mental Health (McKenzie), University of Toronto; Department of Psychiatry (McKenzie), University of Toronto; Institute for Clinical Evaluative Sciences (Urquia, Moineddin, O'Campo, Glazier, Henry, Ray), Toronto, Ont
| | - Richard H Glazier
- Centre for Global Health Research (Jha), St. Michael's Hospital; Centre for Research on Inner City Health (Urquia, O'Campo, Glazier), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Departments of Medicine, and Obstetrics and Gynecology (Ray), St. Michael's Hospital; Dalla Lana School of Public Health (Urquia, Jha, O'Campo, Henry), University of Toronto; Department of Family and Community Medicine (Moineddin, Glazier), University of Toronto; Centre for Addiction and Mental Health (McKenzie), University of Toronto; Department of Psychiatry (McKenzie), University of Toronto; Institute for Clinical Evaluative Sciences (Urquia, Moineddin, O'Campo, Glazier, Henry, Ray), Toronto, Ont
| | - David A Henry
- Centre for Global Health Research (Jha), St. Michael's Hospital; Centre for Research on Inner City Health (Urquia, O'Campo, Glazier), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Departments of Medicine, and Obstetrics and Gynecology (Ray), St. Michael's Hospital; Dalla Lana School of Public Health (Urquia, Jha, O'Campo, Henry), University of Toronto; Department of Family and Community Medicine (Moineddin, Glazier), University of Toronto; Centre for Addiction and Mental Health (McKenzie), University of Toronto; Department of Psychiatry (McKenzie), University of Toronto; Institute for Clinical Evaluative Sciences (Urquia, Moineddin, O'Campo, Glazier, Henry, Ray), Toronto, Ont
| | - Joel G Ray
- Centre for Global Health Research (Jha), St. Michael's Hospital; Centre for Research on Inner City Health (Urquia, O'Campo, Glazier), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Departments of Medicine, and Obstetrics and Gynecology (Ray), St. Michael's Hospital; Dalla Lana School of Public Health (Urquia, Jha, O'Campo, Henry), University of Toronto; Department of Family and Community Medicine (Moineddin, Glazier), University of Toronto; Centre for Addiction and Mental Health (McKenzie), University of Toronto; Department of Psychiatry (McKenzie), University of Toronto; Institute for Clinical Evaluative Sciences (Urquia, Moineddin, O'Campo, Glazier, Henry, Ray), Toronto, Ont
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Urquia ML, Ray JG, Wanigaratne S, Moineddin R, O'Campo PJ. Variations in male-female infant ratios among births to Canadian- and Indian-born mothers, 1990-2011: a population-based register study. CMAJ Open 2016; 4:E116-23. [PMID: 27398354 PMCID: PMC4933604 DOI: 10.9778/cmajo.20150141] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND We assessed variations in the male-female infant ratios among births to Canadian-born and Indian-born mothers according to year of birth, province and country of birth of each parent. METHODS In this population-based register study, we analyzed birth certificates of 5 853 970 singleton live births to Canadian-born and 177 990 singleton live births to Indian-born mothers giving birth in Canada from 1990 to 2011. Male-female ratios were stratified by live birth order and plotted by year of birth. Logistic regression was used to assess whether ratios varied between Canadian provinces and according to the birthplace of each parent. The deficit in the number of girls was estimated using bootstrap methods. RESULTS Among Canadian-born mothers, male-female ratios were about 1.05, with negligible fluctuations by birth order, year and province. Among Indian-born mothers, the overall male-female ratio at the third birth was 1.38 (95% confidence interval [CI] 1.34-1.41) and was 1.66 (95% CI 1.56-1.76) at the fourth or higher-order births. There was little variability in the ratios between provinces. Couples involving at least 1 Indian-born parent had higher than expected male-female ratios at the second and higher-order births, particularly when the father was Indian-born. The deficit in the expected number of girls among Indian immigrants to Canada in the study period was estimated to be 4472 (95% CI 3211-5921). INTERPRETATION Fewer than expected girls at the third and higher-order births have been born to Indian immigrants across Canada since 1990. This trend was also seen among couples of mixed nativity, including those involving a Canadian-born mother and an Indian-born father. Fathers should be considered when investigating sex ratios at birth.
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Affiliation(s)
- Marcelo L Urquia
- Centre for Research on Inner City Health (Urquia, Ray, Wanigaratne, O'Campo), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Dalla Lana School of Public Health (Urquia, O'Campo), University of Toronto; Departments of Medicine and Obstetrics and Gynaecology (Ray), St. Michael's Hospital; Department of Family and Community Medicine (Moineddin), Faculty of Medicine, University of Toronto, Toronto, Ont
| | - Joel G Ray
- Centre for Research on Inner City Health (Urquia, Ray, Wanigaratne, O'Campo), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Dalla Lana School of Public Health (Urquia, O'Campo), University of Toronto; Departments of Medicine and Obstetrics and Gynaecology (Ray), St. Michael's Hospital; Department of Family and Community Medicine (Moineddin), Faculty of Medicine, University of Toronto, Toronto, Ont
| | - Susitha Wanigaratne
- Centre for Research on Inner City Health (Urquia, Ray, Wanigaratne, O'Campo), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Dalla Lana School of Public Health (Urquia, O'Campo), University of Toronto; Departments of Medicine and Obstetrics and Gynaecology (Ray), St. Michael's Hospital; Department of Family and Community Medicine (Moineddin), Faculty of Medicine, University of Toronto, Toronto, Ont
| | - Rahim Moineddin
- Centre for Research on Inner City Health (Urquia, Ray, Wanigaratne, O'Campo), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Dalla Lana School of Public Health (Urquia, O'Campo), University of Toronto; Departments of Medicine and Obstetrics and Gynaecology (Ray), St. Michael's Hospital; Department of Family and Community Medicine (Moineddin), Faculty of Medicine, University of Toronto, Toronto, Ont
| | - Patricia J O'Campo
- Centre for Research on Inner City Health (Urquia, Ray, Wanigaratne, O'Campo), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Dalla Lana School of Public Health (Urquia, O'Campo), University of Toronto; Departments of Medicine and Obstetrics and Gynaecology (Ray), St. Michael's Hospital; Department of Family and Community Medicine (Moineddin), Faculty of Medicine, University of Toronto, Toronto, Ont
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Ngo TD, Keogh S, Nguyen TH, Le HT, Pham KHT, Nguyen YBT. Risk factors for repeat abortion and implications for addressing unintended pregnancy in Vietnam. Int J Gynaecol Obstet 2014; 125:241-6. [PMID: 24726618 DOI: 10.1016/j.ijgo.2013.11.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 11/01/2013] [Accepted: 02/25/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To determine predictors of repeat abortion in 3 provinces in Vietnam. METHODS In a cross-sectional study between August and December 2011, women who underwent abortion were interviewed after the procedure in 62 public health facilities in Hanoi, Khanh Hoa, and Ho Chi Minh City (HCMC). Information on sociodemographic factors, contraceptive and reproductive history and intentions, and opinions and experience of abortion services was collected. The primary outcome was repeat (≥2) abortions. RESULTS Overall, 1224 women were interviewed: 534 from Hanoi, 163 from Khanh Hoa, and 527 from HCMC. The mean age and parity of the respondents were 29 years and 1.8, respectively, and 79.6% were married. Approximately half of the respondents were not using contraception before pregnancy. The prevalence of repeat abortion was 31.7%. In multivariate models, significant predictors of repeat abortion included living in Hanoi, higher parity, age 35 years or older, and having 2 or more daughters (versus 1) or no sons (versus 1) after controlling for parity (all P < 0.05). CONCLUSION Repeat abortion remains high in Vietnam, fueled partly by inadequate contraceptive use. Son preference seems to be an important predictor of repeat abortion. Strengthening post-abortion contraceptive counseling and promoting long-acting contraceptive methods are essential to reduce repeat abortion.
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Affiliation(s)
- Thoai D Ngo
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK; Research, Monitoring and Evaluation Team, Health System Department, Marie Stopes International, London, UK.
| | - Sarah Keogh
- Research, Monitoring and Evaluation Team, Health System Department, Marie Stopes International, London, UK
| | - Thang H Nguyen
- Research and Metrics Team, Marie Stopes International Vietnam, Hanoi, Vietnam
| | - Hoan T Le
- Department of Environmental Health, Hanoi Medical University, Hanoi, Vietnam
| | - Kiet H T Pham
- Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam
| | - Yen B T Nguyen
- Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam
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