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Burns L, Pitt H, Ngoc TL. Adolescent sexual and reproductive health and rights for ethnic minority girls in Vietnam. Health Promot Int 2024; 39:daad182. [PMID: 38234276 PMCID: PMC10794874 DOI: 10.1093/heapro/daad182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024] Open
Abstract
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.
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Affiliation(s)
- Lia Burns
- Institute for Health Transformation, Faculty of Health, Deakin University, 301 Burwood Highway, Burwood, Victoria, 3125, Australia
| | - Hannah Pitt
- Institute for Health Transformation, Faculty of Health, Deakin University, 301 Burwood Highway, Burwood, Victoria, 3125, Australia
| | - Thuy Luu Ngoc
- Social Policy Research Centre (SPRC), Arts, Design & Architecture, University of New South Wales, High Street, Kensington, New South Wales, 2052, Australia
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Phung MT, An PL, Vinh NN, Le HHTC, McLean K, Meza R, Mukherjee B, Lee AW, Pearce CL. A comparative study on behavior, awareness and belief about cervical cancer among rural and urban women in Vietnam. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001817. [PMID: 37279208 DOI: 10.1371/journal.pgph.0001817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/12/2023] [Indexed: 06/08/2023]
Abstract
Cervical cancer is the second most common gynecologic cancer in Vietnam but based on the literature, only ~25% of Vietnamese women reported ever being screened for cervical cancer. To inform strategies to reduce the cervical cancer burden in Southern Vietnam where disease incidence is higher than the national average, this study examined behaviors, awareness, barriers, and beliefs about cervical cancer screening among rural and urban women in this geographical region. In October-November 2021, we conducted a cross-sectional study among 196 rural and 202 urban women in Southern Vietnam; participants completed a cervical cancer screening questionnaire. Descriptive analyses and rural-urban differences in screening behavior, awareness, barriers, and beliefs are presented. About half of the rural and urban participants reported ever being screened for cervical cancer. Most participants showed high perceived severity of cervical cancer and benefits of screening. Further, they reported that they would screen if it was recommended by doctors and/or friends/family. However, most women showed low awareness and perceived susceptibility to cervical cancer. Logistical and psychosocial barriers to physician-based screening methods were reported. Based on our results, the World Health Organization 2030 goals for cervical cancer screening are not currently met in Southern Vietnam. Increasing health literacy and engaging doctors and family members/social networks emerged as important avenues to improve screening. HPV (Human papillomavirus) self-sampling is also a potential approach to increase uptake of cervical cancer screening given the identified psychosocial and logistical barriers.
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Affiliation(s)
- Minh Tung Phung
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
| | - Pham Le An
- Grant and Innovation Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Family Medicine Training Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Nguyen Nhu Vinh
- Family Medicine Training Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Hong H T C Le
- Grant and Innovation Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - Karen McLean
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- Department of Gynecologic Oncology and Department of Pharmacology & Therapeutics, Roswell Park Comprehensive Cancer Center, Buffalo, New York, United States of America
| | - Rafael Meza
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, British Columbia, Canada
| | - Bhramar Mukherjee
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
| | - Alice W Lee
- Department of Public Health, California State University, Fullerton, Fullerton, California, United States of America
| | - Celeste Leigh Pearce
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
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Lundberg PC. Contraception practices among young unmarried women seeking abortion following unintended pregnancy in Ho Chi Minh City, Vietnam. CULTURE, HEALTH & SEXUALITY 2021; 23:1241-1254. [PMID: 32648816 DOI: 10.1080/13691058.2020.1774655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 05/22/2020] [Indexed: 06/11/2023]
Abstract
The aim of this study was to explore and describe contraception practices among young unmarried Vietnamese women seeking abortion after an unintended pregnancy. A qualitative study was conducted with voluntary participation of 42 women at a hospital in Ho Chi Minh City. Interview data were subjected to content analysis from which five categories were identified: (1) attitudes towards sexuality and contraception, (2) knowledge about contraception, (3) use of contraceptive methods, (4) cultural and traditional issues concerning sexuality and contraception, and (5) abortion as a solution to unwanted pregnancy. Prior to their abortion, women had viewed premarital sex as a means of maintaining a relationship with their boyfriends. Misconceptions, misbeliefs, fear of side effects and limited knowledge were reasons for not using contraception and, in case of unintended pregnancy, abortion was the solution. Boyfriends played an important role in influencing the use (or non-use) of contraceptives. Sexual and reproductive health education including counselling for gender equality, safer sex practices and the prevention of unintended pregnancy should be provided to both women and men in ways which combine traditional and modern views of sexuality. Intervention research to develop sexual and reproductive health education programmes, including contraception counselling, should be carried out.
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Affiliation(s)
- Pranee C Lundberg
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Le TM, Yu N. Sexual and reproductive health challenges facing minority ethnic girls in Vietnam: a photovoice study. CULTURE, HEALTH & SEXUALITY 2021; 23:1015-1033. [PMID: 32589104 DOI: 10.1080/13691058.2020.1753813] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 04/06/2020] [Indexed: 06/11/2023]
Abstract
This paper describes a study that examined the challenges faced by Vietnamese ethnic minority girls regarding their sexual and reproductive health. The study employed photovoice, a research method which treats photographs and the accompanying stories provided by participants as qualitative data. Twenty-six (26) minority ethnic girls took photographs of aspects of their lives as a way of documenting the challenges, difficulties and barriers that they faced in looking after their sexual and reproductive health. Findings indicated limited access to sexual health knowledge, the exclusion of young people from mainly adult-focused sexual and reproductive health services in minority ethnic communities and the prevalence of cultural beliefs and practices that negatively affected young people's sexual and reproductive health. The intersection of ethnicity, age and gender places Vietnamese ethnic minority girls at risk, as everyday practices informed by culture and tradition curtail their access to the limited sexual and reproductive health information and services available in their communities. Understanding these challenges is needed in developing appropriate policies, programmes and services aimed at enhancing the sexual and reproductive health of this segment of the population.
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Affiliation(s)
- Trang Mai Le
- Faculty of Social Work, Trade Union University, Hanoi, Vietnam
- Justice and Society, University of South Australia, Adelaide, Australia
| | - Nilan Yu
- Justice and Society, University of South Australia, Adelaide, Australia
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Shatilwe JT, Kuupiel D, Mashamba-Thompson TP. Evidence on access to healthcare information by women of reproductive age in low- and middle-income countries: Scoping review. PLoS One 2021; 16:e0251633. [PMID: 34086686 PMCID: PMC8177524 DOI: 10.1371/journal.pone.0251633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 04/30/2021] [Indexed: 12/02/2022] Open
Abstract
Background A majority of women of reproductive age in low- and middle-income countries (LMICs) are not able to access healthcare information due to different factors. This scoping review aimed to map the literature on access to healthcare information by women of reproductive age in LMICs. Methods The literature search was conducted through the following databases: Google Scholar, Science Direct, PubMed, EBSCOhost (Academic search complete, CINAHL with full text, MEDLINE with full text, MEDLINE, and PsycINFO), Emerald, Embase, published and peer-reviewed journals, organizational projects, reference lists, and grey literature. Results A total of 377 457 articles were identified from all the databases searched. Of these, four articles met inclusion criteria after full article screening and were included for data extraction. The themes that emerged from our study are as follows: accessibility, financial accessibility/affordability, connectivity, and challenges. This study demonstrated that there are minimal interventions that enable women of reproductive age to access healthcare information in terms of accessibility, financial accessibility, and connectivity. Conclusion The findings of the study revealed poor access and utilization of healthcare information by women of reproductive age. We, therefore, recommend primary studies in other LMICs to determine the accessibility, financial accessibility, connectivity, and challenges faced by women of reproductive age in LMICs.
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Affiliation(s)
- Joyce Twahafifwa Shatilwe
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- * E-mail:
| | - Desmond Kuupiel
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Tivani P. Mashamba-Thompson
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Chua B, Ma V, Asjes C, Lim A, Mohseni M, Wee HL. Barriers to and Facilitators of Cervical Cancer Screening among Women in Southeast Asia: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4586. [PMID: 33926019 PMCID: PMC8123618 DOI: 10.3390/ijerph18094586] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/24/2021] [Accepted: 04/24/2021] [Indexed: 01/27/2023]
Abstract
In Southeast Asia, cervical cancer is the second most common cancer in women. Low coverage for cervical cancer screening (CCS) becomes a roadblock to disease detection and treatment. Existing reviews on CCS have limited insights into the barriers and facilitators for SEA. Hence, this study aims to identify key barriers and facilitators among women living in SEA. A systematic literature review was conducted on Pubmed, Embase, PsycINFO, CINAHL, and SCOPUS. Primary qualitative and quantitative studies published in English that reported barriers and facilitators to CCS were included. The Mix Methods Appraisal Tool was used for the quality assessment of the included studies. Among the 93 included studies, pap smears (73.1%) were the most common screening modality. A majority of the studies were from Malaysia (35.5%). No studies were from Timor-Leste and the Philippines. The most common barriers were embarrassment (number of articles, n = 33), time constraints (n = 27), and poor knowledge of screening (n = 27). The most common facilitators were related to age (n = 21), receiving advice from healthcare workers (n = 17), and education status (n = 11). Findings from this review may inform health policy makers in developing effective cervical cancer screening programs in SEA countries.
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Affiliation(s)
- Brandon Chua
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Singapore 117549, Singapore; (B.C.); (M.M.)
- Health Economics and Outcomes Research Centre of Excellence (Greater Asia), Becton, Dickinson and Company, 2 International Business Park Road, Singapore 609930, Singapore;
| | - Viva Ma
- Health Economics and Outcomes Research Centre of Excellence (Greater Asia), Becton, Dickinson and Company, 2 International Business Park Road, Singapore 609930, Singapore;
| | - Caitlin Asjes
- Government and Public Affairs, Becton, Dickinson and Company, 2 International Business Park Road, Singapore 609930, Singapore;
| | - Ashley Lim
- Department of Pharmacy, KK Women’s and Children’s Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore;
| | - Mahsa Mohseni
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Singapore 117549, Singapore; (B.C.); (M.M.)
| | - Hwee Lin Wee
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Singapore 117549, Singapore; (B.C.); (M.M.)
- Faculty of Science, Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore 117543, Singapore
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Gender, sexual experiences and sexual behavioural differences in Turkish university students. J Biosoc Sci 2020; 53:471-480. [PMID: 32631460 DOI: 10.1017/s002193202000036x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study was conducted to determine sexual experiences and gender differences in sexual behaviour in university students. In this cross-sectional and descriptive study conducted between 1st February and 12th November 2017. A total of 491 volunteer students were selected at a state university in the Mediterranean region of Turkey using a systematic sampling method. Questionnaires were distributed to the students in sealed envelopes and collected on completion. The data were collected using a socio-demographic form and a sexual experiences and sexual health behaviours form. A total of 414 students (78 males; 336 females) were included in this study. The prevalence of sexual intercourse among these was 4.3%, and total oral and anal sex experiences were 35% and 16.7%, respectively. A significantly higher number of female students of those who reported having sexual intercourse (n = 9; 50.0%), oral sex (n = 81; 55.9%) and anal sex (n = 60; 87.0%), also reported not telling anyone about his/her partner (77.2%), not talking about sex (82.4%) and not buying contraceptive products, even when necessary (78.3%). Hidden sexuality was seen to affect female students more often and this may lead to risky sexual behaviours, sexually transmitted diseases, an unhealthy sexual life with multiple partners and even unplanned, unwanted pregnancies.
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Thongmixay S, Essink DR, de Greeuw T, Vongxay V, Sychareun V, Broerse JEW. Perceived barriers in accessing sexual and reproductive health services for youth in Lao People's Democratic Republic. PLoS One 2019; 14:e0218296. [PMID: 31661486 PMCID: PMC6818758 DOI: 10.1371/journal.pone.0218296] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 09/20/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Sexual activity during youth is common in Lao PDR. However, young people seldom utilize sexual and reproductive health services and subsequently suffer from poor sexual and reproductive health. The aim of this qualitative study was to explore the barriers perceived by youth that prevent their access to sexual and reproductive health services. METHODS Twenty-nine semi-structured interviews were conducted with 22 participants aged 15-25 years, from urban and rural areas. A vignette was used during interviews with those who had no experience with sexual and reproductive health services. Additionally, seven semi-structured interviews were conducted with health providers from youth-friendly health clinics and from public sexual and reproductive health services. Data were analyzed using a thematic approach. RESULTS The main barriers preventing young people from accessing sexual and reproductive health services were related to cognitive accessibility and psychosocial accessibility. The cognitive accessibility barriers were a lack of sexual knowledge and a lack of awareness of services. Perceived barriers in psychosocial accessibility were the feelings of shyness and shame caused by negative cultural attitudes to premarital sex, and the fear of parents finding out about visits to public sexual and reproductive health services, due to lack of confidentiality in the services and among health providers. In addition, the barriers of geographical accessibility, mainly insufficient availability of youth-friendly health clinics. CONCLUSION To improve access to services, a multi-component strategy is needed: promotion of youth-friendly health clinics; sexual education in schools; a formal referral system between schools and youth-friendly health clinics; and community support interventions. Prior to implementation, more research should be done on the applicability of these methods in the Laos context. Future research should try to determine the cost-effectiveness of youth-friendly health clinics integrated in a district hospital and stand-alone clinics, to provide insight into which form should be further developed.
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Affiliation(s)
| | | | - Tim de Greeuw
- Vrije Universiteit Amsterdam, De Boelelaan, the Netherlands
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