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Vietnam National Sexuality and Sexual Health Survey

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Time: 2007-2010

Funding agency: The Ford Foundation

Rationale

The past decade has witnessed sexuality and reproductive health (SRH) to emerge as a global central concern.  At the International Conference on Population and Development (ICPD) in Cairo (1994) and the Fourth World Conference on Women (FWCW) in Beijing (1995), international consensus has been reached on a comprehensive approach towards reproductive health that emphasizes not only health but also sexual well-beings and empowered social status.  Reproductive health means safe and satisfactory sexual life, reproductive ability, and freedom to make conscious decisions on reproduction.  Particularly, the new approach underlines the interrelation between reproductive health and human rights for achieving human and socio-economic development.

In Vietnam, considerable achievements have been made in advancing reproductive health and gender equality.  The Government has increasingly come to recognize the importance of rights as a requisite condition for development, as reflected in its fundamental governing documents, starting first with the Constitution 1946 and then in other laws. Most recently, the National Strategy on Reproductive Health for the period 2001 – 2010 reaffirms the commitment that Vietnam and other governments have made in Cairo towards investment in reproductive health as a high priority in their country development agenda.  One of the seven objectives of the Strategy calls for raising the awareness of both men and women about sex and sexuality so that they can fully exercise their rights and responsibilities in the area of sexual and reproductive health.

However, to make the Strategy and other relevant policies to be realized, much understanding of sexuality in Vietnam is needed.  So far very little is known about sexuality and sexual health in the country.  The major reason that explains for the lack of knowledge even at the most basic level is that until very recently sexuality and sexual health were still very taboo subjects in Vietnamese families, communities, and institutions. Only the HIV/AIDS epidemic helps bringing sexuality subject out for some toddling discussions and explorations.  Few researches on the subjects are in fact small-scale, and most are of low quality.  Sexuality remains a “black box” with no significant improvement in our understanding of its issues.

Meanwhile, the national setting is rapidly changing.  The dynamism brought about by Doi Moi, while economically obvious, is also social and political.  Thus, what is born from the reforms is not only a robust economic growth but an ever-opening and experiencing society.   Meanwhile, there are alarming reports of rising youth abortion, premarital sexual relationship, sex ratio, STDs and HIV/AIDS infection, prostitution, or sexual violence.

This project proposes an important research to redress these above challenges.  The serious lack of broad and comprehensive knowledge on sexuality of the Vietnamese people not only continues to create, and reproduce, misunderstanding and myths of sex and sexuality but also threatens the high success of any policy and development program.  More seriously, the short of national data has directly harmed the production of sound policies, or policies that are over-general, thus lacking implementation viability.  Meanwhile, society is in urgent needs to have these abovementioned problems effectively resolved.

Thus, it is the right time to have national data on key areas of sexuality of the Vietnamese people, particularly their sexuality knowledge, perceptions, attitudes, and practices.  It is foreseeable that the data collected from the survey, and the follow-up analysis, will be highly appreciated by various government ministries, research institutions, universities, development programs, international actors as well as the general public.  Furthermore, the lack of nationally representative data means that it is not possible to confirm the amounts and types of change that are occurring.  The proposed survey will act as a benchmark from which future surveys can compare and document the amount and pace of change in sexuality.

 

Project objectives

The overall objective of this project is to produce an empirical foundation for a comprehensive understanding of the key issues of sexuality and sexual health in Vietnam and the promotion of sexual well-being, sexual rights and gender equality as indispensable factors for socio-economic and human development in Vietnam.

 

Objective 1. Explore and map present knowledge, perceptions, attitudes and practices towards sexuality of a nationally-representative sample of the Vietnamese people.

In essence, we want to know what current sexuality knowledge, addtitude and practice (KPAP) are among different Vietnamese populations and groups, and how they are cross-varied.  We expect to observe variations between rural versus urban populations, as traditional values and communal ties are theoretically stronger among the former.  Regional differences between the North, the Center, and the South, outcomes of different cultural influences and historical development trajectories are an interesting theme to discover.

Besides these geographical and cultural dimensions, demographic, social and economic dimensions are also important.  Generational gap is the first theme to examine.   Perceptions towards what is “right” or “wrong” behaviors regarding love and sex, for example, is constantly in conflict between parents and children.  We expect to see significant differences between males and females regarding perceptions and practices towards premarital sex as well as other sexual practices.  Also, as a human grows up, his/her sexuality changes along. We can capture this “evolution” through the application of life-story research method.   Social and economic status of a person is also important in how he/she experiences and expresses him/herself as a sexual being.  In the survey, we also want to collect information on issues of homosexuality in Vietnam.  MSM and transgender have long been hidden groups, resulting in societal misunderstanding and consequential stigma and discrimination against them.

In the end, analysis of the data will provide a thorough categorization of sexuality KPAP along all these crucial dimensions.  As a “map”, the organized data provide a bird’s-eye-view of the contemporary sexuality plateau of the today Vietnam.

Objective 2. Identify parameters/boundaries and determinants of Vietnamese sexuality. These are the parameters that help defining what sexuality, or sexualities, of the contemporary Vietnamese like.

In a sense, parameters are trends and patterns. By examining trends and patterns, we can identify areas where policy and intervention efforts can be made to bring about expected changes towards meeting every goal of the Cairo and Beijing commitments.  The ultimate practical purpose is to improve both men’s and women’s sexual well-being that include positive attitudes, pleasure, dignity, and particularly sexual rights.

But in order to do so, we also need to identify key determinants of sexuality KPAP.   Prime independent variables should include: (i) demographic variables (age, gender, ethnicity, religion, marital status, education attainments); (ii) health variables (health status; disability); (iii) economic variables (economic status; occupation); (iv) social variables (social and political status); and (v) space variables (place of residence; migration status).

Similar to the mapping implications, knowledge of the determinants of sexuality KPAP will help areas where intervention measures can bring about significant impact.  The most important area for intervention is indeed gender equality.  Data collected in the survey, once differentiated for females versus males, will highlight the current stage of gender power and relations in Vietnam.  Importantly, the data will suggest clearly which critical issues need to be address, and how, in order to bring about more gender equality in the country.  In fact, gender inequality in sexual relationship is deeply hidden, and this is a very important research interest that we want to examine in the survey.

Objective 3. Trace changes in sexuality KPAP over the past 50 years and the relation between these changes with human development in Vietnam.

This objective in nature is primarily an academic interest.  But it can also be used in an advocacy agenda for sexual right.  What we want to discover in this objective is changes in human sexuality that are interrelated to other socioeconomic transformations and especially human development in the transitional Vietnam.

As a social product and an agency for change, sexuality provides a unique window to observe those transformations.  We figure that through the data collected from the survey, we can evidence a paradigm shift in Vietnamese sexuality.  By paradigm, we means a set of core values regarding sexuality that society relies on in defining what are morally “right” and “wrong”, thus is the frame for reference, orientation and guidance even at individual level.

At the individual level, we will test statistically the cause-effect relationship between variables of sexual well-beings (sexual pleasure, sexual and reproduction freedom, sexual health conditions, rights, etc.) and other indicators of human overall well-beings such as health status, economic conditions, and levels of life satisfactions.  Proofs provided by the analysis of these relationships will convince the audience of the cruciality of promoting sexuality and sexual rights as a human development agenda.

Objective 4. Identify major sexual health issues and their relationship to people’s sexuality KPAP.

The data collected in the survey will also allow us to access the current sexual health situation in Vietnam, for instance the prevalence of unwanted pregnancy, abortion, and infertility which has been considered as being on the rise. We also expect to collect information on sexual violence in its various forms.  Vietnamese government is now preparing an anti domestic violence law.  Data will be conducted too on sources of information of sexual health and services.  Findings of the survey will contribute directly to the policy craft and the design of other related legal documents as well as intervention programs.  Knowledge on determinants of various sexual health issues will be valuable for any intervention efforts that aim at improving sexual health or health in general, of the population.

Methodology

The current survey uses quantitative approach on the ground of profound knowledge of sexuality and sexual health from previous studies using qualitative approach. Over the last few years, ISDS have conducted many qualitative studies on sexuality of various social groups. Experience and findings from those studies play a critical role in implementing and strengthening of the current project. More specifically, ISDS' experience from the previous numerous qualitative studies on sexuality are invaluable for the current project in various tasks, such as forming research questions, adopting and modifying theories, setting up hypotheses, designing valid and reliable questions, and providing persuasive interpretation of the results from they quantitative survey.

Sampling strategy

We plan to conduct a survey of a sample that is nationally representative targeting Vietnamese population aged 18-65 years living in both the rural and urban areas of the eight socio-economic zones across the country.  Purposively, the sample will include about 5,000 individuals of this age cohort.  This sample size is reasonably large enough to produce statistically significant coefficients for key independent variables in multivariate analyses. The sample size and number of enumeration areas (EAs) in the sample will be selected in a manner that taking into consideration the cost of the survey.

Given the complexity and the nation-wide geographic coverage of this study, a multi-stage sampling design is being used. The sample will be clustered to reduce cost of listing all population elements and cost of obtaining observations as is typically found in population-based surveys. The sample will be stratified to reduce the design effect and thereby reduce the sample size required for the survey.  The sampling strategy is designed in a manner that takes into account the regional and rural-urban variations in Vietnam.

Research ethic

Interview team members will approach individuals, explaining the purpose of the interviews, and read them an informed consent statement approved by the institutional review boards.  Oral consents will be obtained prior to the interview.

 

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