Luận văn sexual and reproductive health communication between parents and high school adolescents in vientiane capital, 2019

MINISTRY OF HEALTH UNIVERSITY OF HEALTH SCIENCES, FACULTY OF PUBLIC HEALTH and MINISTRY OF EDUCATION AND TRAINING - MINISTRY OF HEALTH HANOI UNIVERSITY OF PUBLIC HEALTH VISANY VONGSAVANH Sexual and reproductive health communication between parents and high school adolescents in Vientiane Capital, 2019 MASTER OF PUBLIC HEALTH CODE: 8720701 HANOI, 2019 MINISTRY OF HEALTH UNIVERSITY OF HEALTH SCIENCES, FACULTY OF PUBLIC HEALTH and MINISTRY OF EDUCATION AND TRAINING - MINISTRY OF HEALTH HANOI UNIVERSITY OF PUBLIC HEALTH VISANY VONGSAVANH Sexual and reproductive health communication between parents and high school adolescents in Vientiane Capital, 2019 MASTER OF PUBLIC HEALTH CODE: 8720701 Lao supervisor Vietnam supervisor Dr Vanphanom Sychareun Assoc Prof Vu Thi Hoang Lan HANOI, 2019 i ACKNOWLEDGEMENTS This independent study would not have been possible without the help and support of many people I am very thankful to the Ministry of Health of the Lao PDR and the LEARN project for funding my studies at the University of Health Science in Laos and Hanoi University of Public Health in Vietnam The help of the Health Personnel Department, Ministry of Health is also gratefully acknowledged for the leave granted to me to study at University of health science in Laos and Hanoi University of Public Health in Vietnam I would like to thank my thesis advisor Dr Vanphanom Sychareun, Dean, Faculty of Public Health in the University of Health Sciences and Assoc Prof Vu Thi Hoang Lan, Head, Faculty of Fundamental Science in Hanoi University of Public Health, who steered me in the right direction whenever they thought I needed it I also would like to acknowledge the valuable comments and encouragement from the examination chair of my Independent Study Committee as well as the external member of the Independent Study Committee I am most grateful to the directors, teachers and high school students of the Lao-Viet High School and Parkton High School who kindly agreed to help and participate in this research This study could not have been completed without their generous assistance I am grateful as well to all the lecturers, teachers and staff of the UHS and HUPH for their continuous assistance and helpful advice I would like to thank my classmates for their kindness during the period of my studies at UHS and HUPH Finally, I would like to thank my family for their love, understanding, support, and encouragement during the time I studied in Laos and Vietnam Mrs Visany Vongsavanh ii CONTENTS ACKNOWLEDGEMENTS i ABBREVIATIONS iv LIST OF TABLES v LIST OF FIGURES vii ABSTRACT viii INTRODUCTION OBJECTIVES OF STUDY CHAPTER LITERATURE REVIEW 1.1 Definition 1.1.1 Sexual health 1.1.2 Reproductive health 1.1.3 Adolescence 1.2 Adolescent sexual and reproductive health (ASRH) 1.2.1 Importance of SRH among adolescents 1.2.2 Component of sexual and reproductive health 1.2.3 Adolescent-parents communication on SRH issues 1.3 Determinants of adolescent-parents communication on SRH issues 11 1.3.1 Predisposing factors 11 1.3.2 Reinforcing factors 15 1.3.3 Enabling factor 15 1.4 Theoretical framework 16 1.5 Conceptual framework 18 CHAPTER 20 SUBJECTS AND METHODS 20 2.1 Subjects 20 2.2 Setting and duration 20 2.3 Study design 21 2.4 Sample size 21 2.5 Sampling method 22 2.6 Data collection method 23 iii 2.7 Variables 24 2.8 Definitions, measurement and research instrument 24 2.9 Data analysis methods 27 2.10 Ethical issues 28 CHAPTER 29 RESULTS 29 3.1 Socio-demographic characteristics of students and their parents 29 3.2 Communication on SRH issues between adolescents and parents 31 3.3 Determinants of SRH communication between high school adolescents and their parents in Vientiane Capital 39 CHAPTER 46 DISCUSSION 46 CONCLUSION 52 RECOMENDATIONS 53 REFERENCE 54 ANNEXES 59 Annex 1: Table of definitions and measurements of variables in the study 59 Annex 2: English version questionnaire 63 Annex 3: Information sheet and consent form (English version) 71 Annex 4: Certificate of approval 77 Annex 5: Thesis comments 79 Annex 6: Minutes of explanation 85 iv ABBREVIATIONS AIDS Acquired immune deficiency syndrome ASRH Adolescent sexual and reproductive health HIV Human immunodeficiency virus ICPD International Conference on Population and Development LSB Lao Statistics Bureau LYU Lao People‟s Revolutionary Youth Union MOE Ministry of Education and Sports MOH Ministry of Health RH Reproductive health SDGs Sustainable Development Goals SRH Sexual reproductive health SRHR Sexual reproductive health right STDs Sexually transmitted diseases STIs Sexually transmitted infections UN United Nations UNFPA United Nations Fund for Population Assistance UNICEF United Nations Children‟s Emergency Fund WHO World Health Organization v LIST OF TABLES Table 2.1: Proportion of students selected in each grade 23 Table 3.1: Socio-demographic characteristics of students in Vientiane Capital 29 Table 3.2: Socio-demographic characteristics of their parents 30 Table 3.3: Content of SRH communication between high school adolescents and their fathers in Vientiane Capital 31 Table 3.4: Content of SRH communication between high school adolescents and their mothers in Vientiane Capital 32 Table 3.5: Communication on SRH issues between adolescents and parents in Vientiane Capital 33 Table 3.6: Reasons high school students did not communicate with fathers on SRH issues in Vientiane Capital, January 2019 34 Table 3.7: Reasons of high school students did not communicated with mothers on SRH issues in Vientiane Capital, January 2019 35 Table 3.8: Attitudes towards general and SRH communication with parents 36 Table 3.9: Reasons for adolescents‟ choice of influential person to communicate with on SRH issues 37 Table 3.10: Reasons for accessibility to SRH information sources 38 Table 3.11: Bivariate analysis of individual-demographic factors associated with SRH communication between students and parents in Vientiane Capital 39 Table 3.12: Bivariate analysis of parent demographic factors associated with SRH communication between students and parents in Vientiane Capital 40 Table 3.13: Bivariate analysis of attitudinal factors associated with SRH communication between students and their parents in Vientiane Capital 41 Table 3.14: Bivariate analysis of influential person factor associated with SRH communication between students and their parents in Vientiane Capital 42 vi Table 3.15: Bivariate analysis of resource factors associated with Sexual and RH communication between students and their parent in Vientiane Capital 43 Table 3.16: Multivariate analysis of factors associated with SRH communication between students and their parents in Vientiane Capital 44 vii LIST OF FIGURES Figure 1: Conceptual framework of SRH communication between high school adolescents and their parents in Vientiane Capital 19 Figure 2: Flow chart of sampling procedure 22 viii ABSTRACT Adolescent health has become a priority on the global health agenda with the added focus on addressing adolescent health in low and middle-income countries Many adolescents not feel comfortable discussing reproductive health with their parents However, when parents are more concerned about the values of their children, adolescents more often develop positive, healthy attitudes about themselves.The aim of this study was to describe the situation of SRH communication, and to determine the factors associated with SRH communication between high school students and their parents in Vientiane Capital This is an analytical study with a cross sectional design to collect quantitative data though a self-administered questionnaire The study population were 384 high school students aged 14-17 years old in Vientiane Capital were recruited in this study A multistage sampling technique was applied SRH communication in this study was recorded as the frequency with which adolescents discussed with their parents at least four topics on SRH issues during a six month period prior to the interview Data were entered and analyzed through Epi Data software version 6.0 and STATA version 14.2 Descriptive statistics were employed In addition, multiple logistic regression was applied to determine the factors associated with dependent variables The main result was that slightly higher than one fifth of the students (21.3%) communicated with parents on SRH issues The multivariate logistic regression model showed that male adolescents (AOR = 2.1; 95% CI : 1.2-3.5), urban school location (AOR = 0.2; 95% CI : 0.1-0.5), older age of father (AOR = 1.7; 95% CI: 1.0-2.9), positive attitudes towards general communication with parents (AOR = 2.2; 95% CI: 1.1-4.2) and accessibility to multiple SRH information sources (AOR = 5.2; 95% CI: 2.4-11.4) were significantly associated with adolescents-parents communication on SRH issues (P-value < 0.05) This study showed only a low proportion of students communicated on SRH issues with their parents Parents should focus on both male and female students equally in discussing SRH issues Policy makers should develop programs to improve SRH communication skills in all schools and encourage open discussion with family members In addition, positive attitudes of students and multiple sources of SRH information were also important factors in improving SRH communication Keywords: sexual reproductive health, communication, adolescents, Vientiane Capital