(Luận văn) qualitative analysis of sexual health protection behavior by income – the case of ho chi minh city

t to ng hi ep UNIVERSITY OF ECONOMICS HO CHI MINH CITY VIETNAM INSTITUTE OF SOCIAL STUDIES THE HAGUE THE NETHERLANDS w n VIETNAM - NETHERLANDS PROGRAMME FOR M.A IN DEVELOPMENT ECONOMICS lo ad ju y th yi pl n ua al n va QUALITATIVE ANALYSIS OF SEXUAL HEALTH PROTECTION BEHAVIOR BY INCOME – THE CASE OF HO CHI MINH CITY ll fu oi m at nh z z BY k jm ht vb LE THI PHUONG THAO om l.c gm an Lu MASTER OF ARTS IN DEVELOPMENT ECONOMICS n va ey t re th HO CHI MINH CITY, OCTOBER 2012 t to ng hi ep UNIVERSITY OF ECONOMICS HO CHI MINH CITY VIETNAM INSTITUTE OF SOCIAL STUDIES THE HAGUE THE NETHERLANDS w n VIETNAM - NETHERLANDS PROGRAMME FOR M.A IN DEVELOPMENT ECONOMICS lo ad ju y th yi pl n ua al QUALITATIVE ANALYSIS OF SEXUAL HEALTH PROTECTION BEHAVIOR BY INCOME – THE CASE OF HO CHI MINH CITY n va ll fu m oi A thesis submitted in partial fulfilment of the requirements for the degree of at nh MASTER OF ARTS IN DEVELOPMENT ECONOMICS z z om l.c gm LE THI PHUONG THAO k jm ht vb By n va DR PHAM KHANH NAM an Lu Academic Supervisor: ey t re th HO CHI MINH CITY, OCTOBER 2012 t to ng Table of Contents hi ep Chapter : Introduction Problem Statement 1.2 Research Objectives 1.1 w n Research Structure 10 ad 1.4 Research Scope 10 lo 1.3 y th Chapter : Literature reviews 11 ju Theory of Planned Behavior 11 2.2 Empirical Studies 13 2.3 Chapter Summary 16 yi 2.1 pl ua al Research backgrounds and research methodology 17 n Chapter : va Research backgrounds 17 3.2 Research Methodology 19 n 3.1 ll fu Analytical framework……………………………………………………… 19 3.2.2 Qualitative methods…………………………………………………………21 3.2.3 Tool………………………………………………………………………….25 3.2.4 Participants and studied location…………………………………………….29 at nh z z ht vb Chapter Summary 32 Empirical results 33 jm Chapter : Description of variables 33 k 4.1 oi 3.3 m 3.2.1 gm Attitude and perception…………………………………………………… 33 4.1.2 Subjective Norms……………………………………………………………39 4.1.3 Perceived Behavior Control…………………………………………………41 om Determinants of sexual health protection behavior 45 an Lu 4.2 l.c 4.1.1 Subjective Norms and sexual health protection behavior………………… 47 4.2.3 Perceived behavior control and sexual health protection behavior………….48 Chapter Summary 49 ey 4.3 t re 4.2.2 n Attitude/perception and sexual health protection behavior………………….45 va 4.2.1 th t to ng Chapter 5: Conclusions and policy implication 50 hi ep 5.1 Conclusions 50 5.2 Policy Implication 51 5.3 Limitation 52 w n REFERENCES 53 lo ad Appendix A 56 y th Appendix B 59 ju Appendix C 61 yi pl Appendix D 63 n ua al n va ll fu oi m at nh z z k jm ht vb om l.c gm an Lu n va ey t re th t to ng Table of Figures hi ep Figure 1: Theory of Planned Behaviour 20 Figure 2: The layer of needs 26 w Figure 3: The collages of NeedScope model 28 n lo ad ju y th yi pl n ua al n va ll fu oi m at nh z z k jm ht vb om l.c gm an Lu n va ey t re th t to ng List of Tables hi ep Table 1: Sample information 30 Table 2: Attitudes and Perception variable 43 w Table 3: Subjective Norms variable 43 n lo Table 4: Perceived Behavioural Control variable 44 ad Table 5: Behaviour variable 44 ju y th yi pl n ua al n va ll fu oi m at nh z z k jm ht vb om l.c gm an Lu n va ey t re th t to ng hi ep Abbreviations Attitudes and Perception EC Emergency Contraception A&P w n Focus discussion group lo FDG ad HCMC y th HIV/AIDS Ho Chi Minh city Human Immunodeficiency Virus/ Acquired Immunodeficiency Syndrome ju In-deep interview IUD Intrauterine Device RH Reproductive Health STI Sexual Transmission Infection UNFPA United Nations Fund for Population Activities WHO World Health Organization yi IDI pl n ua al n va ll fu oi m at nh z z k jm ht vb om l.c gm an Lu n va ey t re th t to ng hi Chapter : Introduction ep 1.1 Problem Statement w n Ho Chi Minh city is the biggest city in Vietnam with the estimated total of residents at lo ad about 7.2 million including of 2.3 million of males and 2.4 million of females which are in ju y th the age from 15 to 65 (Statistical Office in HCMC, 2010) Along with the development of urbanization, industrialization and globalization, yi pl social and cultural life has many changes in recent years However, as the traditional ua al notions in Vietnam and other Asian countries, sexual content is taboo for talking in public n Meanwhile, as said above, the impressive growth of economy also brings the huge change va n of society, including the sexual health issues In which, the main sexual and reproductive ll fu health issues are sexual transmitted infection, unplanned pregnancy and unsafe abortion oi m (Low, 2006) Proportion of women in reproductive age suffer STIs is 25%, proportion of nh abortion and menstrual regulation is 0.8% (UNFPA, 2009) at HIV / AIDS in Vietnam is really an alarming problem 156,802 people living with HIV z z were reported, including 34,391 AIDS patients alive and 44,232 people died because of vb ht AIDS So far, HCMC is the highest cases of people who are living with HIV accounted for k gm primarily through heterosexual sex and injecting drug use jm 26.3% of HIV cases detected in the country (Ministry of Health, 2010) HIV transmission is l.c However, the biggest challenge facing Vietnam in the field of RH is the issue of om abortion The use of contraceptive method is reflected in low rate while the abortion rate an Lu continues to rise in Vietnam The average women abortion rate is 2.5 times This number was the highest in Southeast Asia and was one of the highest rates in the world Strikingly, th ey asking their partner to use condoms Furthermore, a negative view on abortion has caused t re women lacked basic knowledge about sex, including not believing in using condoms or not n awareness of people, they not really change their behaviour apparently Many young va while education program and media communication system have attempted to raise t to ng many women choose the unsafe and illegal abortions In Vietnam, mortality rate from hi unsafe abortions is one per week ep In Vietnam, sex education in school already gives the basic knowledge, such as w biology, gender and personal development, hygiene, and family life However, the teaching n lo methods used are often not suitable for sensitive topic like this (WHO, 1999) School is ad main source to provide knowledge about sexual health, but this information is poor and y th unelaborated Teachers still avoid mentioning about this topic in their lectures (Nguyen et ju yi al., 1999), which brings the lack of sufficient and efficient information and causes the pl curiosity to the adolescent about sexual health So, it could lead to the shortage in sexual n and abortion ua al health protection, insufficient knowledge about transmission diseases, unplanned pregnancy va n As the economy of HCMC has been growing rapidly, rising in income and income fu ll inequality has probably changed many of people’s behaviour, including sexual health m oi protection behaviour However, the relationship between protection behaviour and income, at nh which has important policy implication, has not been fully understood The income has positive correlation with education factor (Pereira and Martins, 2004), but not with sex z z health protection behaviour This study also tries to figure out what the difference between vb Research Objectives k 1.2 jm ht income groups in intended behaviour towards sexual health protection gm From this problem statement, this research examines the sexual health protection behavior l.c of urban HCMC participants using qualitative method First of all, this research try to find om out the attitudes and perception (A&P) towards sexual health protection, subjective norm an Lu about sexual health protection and perceived behavioral control of sexual health protection behavior Besides, this research also tries to exam the relationship between A&P and sexual ey t re Moreover, this research tries to figure out these connections by income groups, including n behavior, between perceived behavioral control and sexual health protection behavior va health protection behavior, between subjective norms and sexual health protection th low-income and high-income groups t to ng 1) What is the attitudes and perception, subjective norms, perceived behavioral control hi towards sexual health care/protection? ep 2) What is the connection between attitudes and perception, subjective norms, w perceived behavioural control to sexual health protection behaviour? n lo 3) What are the differences in these connections among income group? ad Research Scope ju y th 1.3 yi This research was carried out in HCM city The sample size was 21 participants, including pl male and 14 female, aged from 18-40 years old al Research Structure n ua 1.4 n va The based theory of this study is presented at chapter 2; then, followed by empirical study ll fu Chapter reviewed research backgrounds and research methodology, in which study m presented about analytical framework, qualitative method: explain why we should use oi qualitative method for this research, tool to the research: we use NeedScope model nh at during the interview, and interpretation about the participants of this study Chapter point z out some results of the study, then chapter gave some conclusion and policy z k jm ht vb recommendation om l.c gm an Lu n va ey t re th 10