Luận văn youths satisfaction with sexual transmitted infections services providing in vientiane capital, laos 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 AKSONE VONGKHILY H P YOUTHS’ SATISFACTION WITH SEXUALLY TRANSMITTED INFECTIONS SERVICES PROVIDED IN U VIENTIANE CAPITAL, LAOS 2019 H MASTER OF PUBLIC HEALTH CODE: 8720701 HANOI, 2020 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 AKSONE VONGKHILY H P YOUTHS’ SATISFACTION WITH SEXUAL TRANSMITTED INFECTIONS SERVICES PROVIDING IN VIENTIANE CAPITAL, 2019 U MASTER OF PUBLIC HEALTH CODE: 8720701 H SUPERVISORS: DR KHAMPHENG PHONGLUXA DR DUONG MINH DUC HEAD OF DEPARTMENT OF LECTURER, DEPT.OF POPULATION-REPRODUCTIVE COORDINATION AND RESEARCH HEALTH FACULTY OF SOCIAL SCIENCES - HEALTH INFORMATION MANAGEMENT, EDUCATION & BEHAVIOUR, LAO TROPICAL AND PUBLIC HANOI UNIVERSITY OF PUBLIC HEALTH HEALTH INSTITUTE HANOI, 2020 i ACKNOWLEDGEMENTS This independent study would not have been possible without the help and support of many people I am very grateful to the Ministry of Health of the Lao PDR and the LEARN project for funding my studies at the University of Health Sciences (UHS), the Lao-THPI in Laos and the Hanoi University of Public Health (HUPH) in Vietnam The help from the Vientiane Women’s and Youth Center for Health and Development of the Laos Women’s Union, Vientiane Capital, and all their staff is also gratefully acknowledged for allowing me to study at the UHS in Laos and the HUPH in Vietnam H P I would like to offer thanks to my thesis advisors Dr Khampheng Phongluxa, MD, MSc, PhD, Head of the Department of Coordination and Research Information Management, at the Lao Tropical and Public Health Institute and Dr Duong Minh Duc, PhD., Lecturer, the Faculty of Social Sciences, Health Education and Behaviour, HUPH, who steered me in the right the direction whenever they thought I needed it U I would also like to acknowledge the valuable comments and encouragement from the examination chair of my Independent Study Committee and also wish to thank the external member of the Independent Study Committee H I am most grateful to the directors of the Vientiane Youth Center and the National Dermatology Center, whose facilitators 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, the Lao-TPHI and HUPH for their continuous assistance and helpful advice I would like to offer special thanks to Dr Somphou Outensackda and 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 Aksone VONGKHILY ii ABBREVIATIONS & ACRONYMS AIDS Acquired Immune Deficiency Syndrome HIV Human Immune-deficiency Virus Lao PDR Lao People’s Democratic Republic LPRYULYU Lao People’s Revolutionary Youth Union/Lao Youth Union NDC National Dermatology Centre VYC Vientiane Youth Centre SRH Sexual and Reproductive Health STIs Sexual Transmitted Infections STDs Sexual Transmitted Diseases UNFPA United Nations Population Fund YFS Youth Friendly Service WHO World Health Organization H U H P iii CONTENTS ACKNOWLEDGEMENTS I ABBREVIATIONS & ACRONYMS II LIST OF TABLES .VI SUMMARY VIII INTRODUCTION RESEARCH OBJECTIVES CHAPTER LITERATURE REVIEW 1.1 YOUTH H P 1.2 SEXUALLY TRANSMITTED INFECTIONS (STIS) 1.3 SEXUALLY TRANSMITTED INFECTIONS AMONGST YOUTHS AROUND THE WORLD AND IN LAOS 1.3.1 STI OCCURRENCE AMONGST YOUTHS AROUND THE WORLD 1.3.2 STIS AMONGST YOUTHS IN LAOS U 1.4 STI SERVICES IN THE WORLD 1.5 STI SITUATION AND SERVICES FOR YOUTH IN LAOS 1.6 THE LAO GOVERNMENT POLICY ON STIS H 1.7 STI SERVICES IN VIENTIANE CAPITAL 1.8 CONCEPT OF SATISFACTION 1.8.1 PATIENT SATISFACTION WITH STI SERVICES 1.9 ASSOCIATED FACTORS AFFECTING YOUTH SATISFACTION WITH STI SERVICES 12 1.10 CONCEPTUAL FRAMEWORK 15 CHAPTER 17 METHODOLOGY 17 2.1 STUDY POPULATION 17 2.1.1 INCLUSION CRITERIA 17 2.2.2 EXCLUSION CRITERIA 17 2.2 STUDY SITE AND DURATION OF DATA COLLECTION 18 2.3 STUDY DESIGN 18 iv 2.4 SAMPLE SIZE 18 2.5 SAMPLING METHOD 19 2.6 DATA COLLECTION 19 2.7 VARIABLES OF THE STUDY 20 2.8 RESEARCH INSTRUMENT AND MEASUREMENT 21 2.8.1 RESEARCH INSTRUMENT 21 2.8.2 MEASUREMENT OF YOUTHS’ SATISFACTION 22 2.8.3 MEASUREMENT OF EXPECTATIONS WHEN RECEIVING STI SERVICES 23 2.9 DATA ANALYSIS METHOD 24 H P 2.10 ETHICS STATEMENT 24 CHAPTER 26 RESULTS 26 3.1 SOCIO-DEMOGRAPHIC CHARACTERISTICS 26 3.2 YOUTH’S SATISFACTION WITH STI SERVICES 28 3.3 MEDICAL SITUATION OF THE YOUTH AND THEIR EXPECTATIONS WHEN U RECEIVING THE SERVICES 34 3.3.1 MEDICAL SITUATION MOTIVATING THE YOUTHS TO VISIT THE STI SERVICES 34 H 3.3.2 EXPECTATIONS WHEN RECEIVING STI SERVICES 36 3.4 UNIVARIATE LOGISTIC REGRESSION ANALYSIS OF THE ASSOCIATION BETWEEN THE SOCIO-DEMOGRAPHIC FACTORS AND THE YOUTHS’ SATISFACTION WITH THE STI SERVICES 39 3.5 UNIVARIATE LOGISTIC REGRESSION ANALYSIS OF THE ASSOCIATION BETWEEN THE MEDICAL SITUATION OF THE YOUTH, THEIR EXPECTATIONS WHEN RECEIVING STI SERVICES AND THEIR SATISFACTION WITH THE SERVICES 42 3.6 UNIVARIATE ANALYSIS OF THE ASSOCIATION BETWEEN EXPECTATIONS WHEN RECEIVING STI SERVICES AND THE SATISFACTION WITH THE SERVICES 45 v 3.7 MULTIVARIATE LOGISTIC REGRESSION ANALYSIS OF THE FACTORS ASSOCIATED WITH THE YOUTH’S SATISFACTION WITH THE STI SERVICES 45 CHAPTER 48 DISCUSSION 48 CONCLUSION 59 RECOMMENDATIONS 60 REFERENCES 61 ANNEX 70 ANNEX 1: TABLE OF DEFINITIONS AND MEASUREMENT OF VARIABLES IN H P THE STUDY 70 ANNEX 2: QUESTIONNAIRE 73 ANNEX 3: INFORMED CONSENT FORM FOR ADOLESCENTS 80 ANNEX 4: PARENTAL/LEGAL GUARDIAN’S CONSENT FORM 81 ANNEX 5: LAO ETHICAL APPROVAL 82 ANNEX 6: VIETNAM ETHICAL APPROVAL 83 U ANNEX 7: THESIS COMMENTS 84 ANNEX 8: MINUTES OF EXPLANATION 91 H vi LIST OF TABLES Table 3.1: Distribution of socio-demographic characteristics of youths visiting the STI services at the Vientiane Youth Center and the National Dermatology Center (n=217) 26 Table 3.2: Interpersonal manner of health providers 28 Table 3.3: Counselling skills of providers 29 Table 3.4: Physical environment 30 Table 3.5: Availability of services 30 Table 3.6: Accessibility of services 31 Table 3.7: Affordability of fees 32 Table 3.8: Efficiency of services 32 H P Table 3.9: Overall satisfaction of youth towards STI services in Vientiane Capital (n=217) 33 Table 10: STI symptoms motivating youths to visit the STI services (n=217) 34 Table 3.11: Diagnosis of the sexually transmitted infections (n=217) 34 Table 3.12: Current status of STI infection (n=217) 35 Table 3.13: Distribution of health care facilities that the youth have utilized (n=217) 36 U Table 3.14: Expectations about the manner of the service providers (Respect, Friendliness, Concern and Courtesy) (n=217) 36 Table 15: The status of youth’s expectations when receiving STI services (n=217) 38 H Table 3.16: Level of satisfaction with STI services (n=217) 39 Table 3.17: Association of socio-demographic factors and the satisfaction with STI services (n=217) 39 Table 3.18: Association between the medical situation of the youth and their satisfaction with the services 42 Table 3.19: Association between expectations when receiving STI services and the satisfaction with the services 45 Table 3.20: Associated factors and youth’s satisfaction with STI services 45 vii Independent Study Title Youth Satisfaction with the Provision of Sexually Transmitted Infection Services in Vientiane Capital, 2019 Author Mrs Aksone VONGKHILY Degree Master of Public Health Major Field/ Faculty/ University University of Health Sciences, Faculty of Public Health, and Hanoi University of Public Health Independent Study Advisors Dr Khampheng Phongluxa H P Head of Department of Coordination and Research Information Management, Lao Tropical and Public Health Institute Dr Duong Minh Duc Lecturer, Department of Population and Reproductive U Health, Faculty of Social Sciences - Health Education & Behaviour, Hanoi University of Public Health Academic Years H 2018-2020 viii SUMMARY Sexually transmitted infections (STIs) are a major burden for disease control worldwide, particularly among youths In the Lao PDR, youths acquire STIs due to an insufficient knowledge of safe sex and STIs, as well as poor access to sexual and reproductive health services Patient satisfaction enhances the image of health care facilities and translates into increased service use The aim of this study is to investigate the youths’ satisfaction with STI services in Vientiane Capital, and identify its associated factors A cross-sectional analytical study was applied using quantitative methods The study interviewed 217 youths aged 15-24 who were seeking care at the STI Unit of the Vientiane H P Youth Center (VYC) and the National Dermatology Center (NDC) The collected data was entered into the Epidata program (Version 3.1) and then transferred to the STATA software (Version 14.2) for further analysis Descriptive and inferential statistics analyses were performed to determine the factors associated with satisfaction relating to STI services U The findings showed that of 217 youths, 74.6% were aged 21-24 years, 78.8% were single and 78.3% of them belonged to the Lao ethnic group Almost three fifths of the students were male, and nearly 40% had attended university, while over two fifths were currently H enrolled as students More than a third of the youths had a monthly income of between 1.1-1.5 million LAK Pertaining to their satisfaction with STI services, more than four fifths of youths were pleased with the STI services The most significant factors identified associated with a satisfaction with STI services were having a monthly income of between 1.1-1.5 million LAK, having experienced a visit to STI services before and expecting to receive good services (AOR) In conclusion, this study has demonstrated that most youths are satisfied with the provision of STI services in Vientiane Capital Youths with a moderate income, a prior experience of using STI services and who held positive expectations while receiving services were found to be the influencing factors linked to a satisfaction with STI services Therefore, to increase STI service use among youths, youth friendly services including the promotion