Knowledge about safe sex and the needs on providing information on reproductive health among students at the high school number 2 Hiep Hoa district, Bac Giang province in 2015

MINISTRY OF EDUCATION AND TRAINING

MINISTRY OF HEALTH

HANOI MEDICAL UNIVERSITY

LIT LIEN HUONG

KNOWLEDGE ABOUT SAFE SEX AND THE NEEDS ON

PROVIDING INFORMATION ON RE PRODVC TIM HEALTH

AMONG STI DENTS AT THE HIGH SCHOOL NUMBER 2.

HIEP HOA DISTRICT. BAC GIANG PROVINCE IN 2015

GRADUATION THESIS OF MEDICAL BACHELOR
Course: 2011 - 2015

Supervisor: Ass. Prof. NGUYEN THITHUY HANH

HANOI 2015


ACKNOWLEDG FA IE NT

Forenrost. I would like to thank the Boards of Hanoi Medical University
and Institute for Preventive Medicine and Public Health as well as the
teachers in the Department of Demography for supporting me to do this

graduation thesis in the most convenient conditions.

I would like to express my respectful gratitude to my supervisor. Ass.

Prof. Nguyen T1Ũ Thuy Hanli. for giving me an opportunity working with her
and having the experiences, for many valuable lessons, not only in

professional knowledge but also in life skills.

I am grateful to the students and also for their enthusiasm in answering the
questionnaire, also to the Boards of tire high school number 2. Hiep Hoa

district. Bac Giang province for their cooperation during field work.

I would like to thank my friends for helping me in the progress of

studying and completing my graduation thesis.
Last but not least. I would like to give many thanks to my family,

especially my mother, for Iter encouragement to me in study process as well
as support me to overcome many challenges in my life

Luu Lien Huong


COMMITMENT
Respectfully addressed to:

The Boards of Training - Hanoi Medical University
- The

Boards

of

Training.

Health

Research

and

International

Collaboration - Institute for Preventive Medicine and Public Health

The Department of Demography
- The Boards of Di ssertation Assessment

I guarantee that this is my own thesis. The data and results presented in
this thesis are to the best of my knowledge, true and accurate. The work
contained in this study has not been submitted elsewhere, as pan of any other

degree or assignment. I contend that the work presented in this thesis is my
own. except in instances where due references have been made to other
referenced material.

The author of thesis

Luu Lien Huong

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ABBREVIATIONS
ARH

Adolescent reproductive health

ECP

Emergency contraceptive pill

FGD

Focus group discussion

ICPD

The International Conference of Population and Development

1DI

hl-depth interview

HIV'AIDS

Human Immunodeficiency Virus infection and Acquired

Immune Deficiency Syndrome
SAVY

The Survey Assessment of Vietnamese Youth

STD(s)

Sexual Transmined Disease(s)

UNICEF

The United Nanon Children's Fund

WHO

World Health Organization

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T ABLE OF CONTENT

••

CHAPTER 1. LITERATURE REXTEW.............
1.1. Definitions and concepts.

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1.1.1. Definition of adolescence.....................

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••

•••••

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1.1.2. Definition of reproductive health..

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••• ••

1.1.3. Definition of contraceptive methods ... • ••••■•

••

•••••••••• •

1.1.4. Definition of safe sex..... .....................

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1.1.5. Contents of reproductive health education among adolescents
1.2. The situation about reproductive health among adolescents........

1.2.1. In the world

6

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...... 7

1.2.2. In Vietnam
1.3. Knowledge of adolescents about safe sex...............................

...... 8

1.3.1. In the world • •••••••••a •••••••••••••••••••••••••••••••••••••••••••••••••••••••• •■•••••••••
1.3.2. In Vietnam................... .

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1.4. Information about reproductive health among adolescents..
1.4.1. In the world. ã ã ãôããôãããããããããôãããã Iôããããããããôãããã I ãããããã (I ãããããôãããããããã

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1.4.2. In Vietnam ôãôô aw aôôô*r aa ãôô aaaaôô*raa ãôôããã at ôôôfaaaô(ôô*veat*tôaaôiôô*at aôôfôa >ôããôằããã

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12

1.5. The situation of education about reproductive health at the high school
number 2 of Hi ep Hoa District
13

CHAPTER 2. RESEARCH METHODS.................................................. .... 15
2.1. Stud}’ setting..............

• ••••

2.2. Stud}’population...

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2.3. Time of stud}’...........

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2.4. Studs’design

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2.4.1. Study design......
2.4.2. Sample size

2.43. Sampling method

16

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2.5. Variables • •••■••••••••••■••••••••••••••••••••••a*

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2.6. Data collection process

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2.6.1. Data collection tools................

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2.6.2. Data collection process
2.6.3. Data management and analysis

2.7. Bias and controlling.......................
2.8. Ethical considerations.

CHAPTER 3. RESULTS

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3.1. Characteristics of study subjects....
3.1.1. Quantitative research.........

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3.1.2. Qualitative research

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25

3.2. Knowledge about safe sex among students.
3.2.1. Knowledge about fertility and contraceptive methods

27

3.2.2. Knowledge about safe sex and consequences of unsafe sex..

32

3.3. The needs of providing information about reproductive health ...

34

3.3.1. The situation of providing information about reproductive health

• ••••••••••••••••••• 34

among students.

3.3.2. The needs of providing information about reproductive health

among students • •••••»• ..... f ......f

f ....................... w. .. t ........ Í .... t •• • .. «••«««•• 39

CHAPTER 4. DISCUSSION.................................

4.1. Lack of knowledge about safe sex among students............................... 45
4.1.1. Knowledge about fertility and contraception.................................. 45
4.1.2. Knowledge about safe sex and the consequences of unsafe sex.... 48

4.2. The need ofproviding information on reproductive heal til.................. 49
4.2.1. The limitation of accessing information about reproductive health

among students

49

4.2.2. Tire needs ofproviding information on reproductive health......... 52

4.3. Limitations of the study.......................................................................... 55

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CONCLUSIONS
RECOMMENDATIONS

REFERENCES
APPENDIX

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58


LIST OF TABLES
Table 3.1: Characteristic of respondents in quantitative study........................ 24
Table 3.2: Characteristics of students in qualitative study.............................25
Table 3.3: Characteristics of interviewed teachers......................................... 26
Table 3.4: Knowledge of students about fertility.............................................27
Table 3.5: Knowledge of students about contraceptive methods...................28
Table 3.6: Knowledge of students about emergency contraceptive pill (ECP)
Table 3.7: Knowledge of students about safe sex and the consequences of
unsafe sex....

32

Table 3.8: The situation of finding ARH information among students......... 34
Table 3.9: The providing of reproductive health information at school.........37
Table 3.10: The contents that students want to be informed........................... 39

Table 3.11: The needs of providing information at school among students... 42

LIST OF FIGURES

Figure 3.1: The number of student thought that abortion is a contraceptive
method..
Figure 3.2: The knowledge of students about STDs........................................ 33
Figure 3.3: Evaluate about knowledge of students......................................... 34
Figure 3.4: The contents of reproductive health that students received........ 36
Figure 3.5 : The information sources that students received.......................... 36

Figure 3.6: The information sources that students want to receive............... 41

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INTRODUCTION
Adolescence is a transition stage between childhood and adulthood.

According to World Health Organization (WHO). adolescents are young
people between the ages of 10 and 19 years. It is characterized by tile
physical, social and emotional changes in puberty. The most important change

of adolescents at this stage is the change of reproductive system, which makes
them more sexually active than before. Therefore, there is a significant rise of
the need to be informed about reproductive health especially about safe sex

among adolescents [1]. However, providing information about this content to
adolescents is still neglected in many countries of the worlds, and Vietnam is
one of them. These may lead to serious consequences such as unexpected

pregnancy, contracted to STDs or abortion if adolescents have sex.
According to Survey Population and Family planning in 2013, the

proportion of adolescents in Vietnam is 15.6%. much higher than many other
developing countries [2J. Adolescents in Vietnam have faced many problems
as those from many parts of the world. Singula: mean age at sex in Vietnam is

decreasing, from 19.6 in SAVY I to 18.1 in SAVY II aid the proportion of

adolescents having intercourse before marriage is increasing, from 7.6% in
SAVY 1 to 9.5°/« in SAVY II [3], Although the percentage of abortion in

Vietnam is decreasing in recent 10 years, this percentage of adolescent tends
to be increasing, with about 20% of the total abortion cases. This rate is
highest in Southeast Asia and the fifth highest in the world [4], Abortion at

teenager may cause some consequences, such as infection, miscaniage next

time, secondary infertility and mental disorders [5]. The proportion of

adolescents contracting to HIV/AIDS was 1.8% with under 13 years old
groups. 4.11% with 13 to 19 years old group [6]. To reduce all of these

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consequences, adolescents need to be informed about adolescent reproductive
heal til.

In recent years, there have been some studies on this issue. Tire results of
these researches showed that knowledge of adolescents about reproductive

health was still limited, and there was any improvement during 6 years, from
SAVY I (2003) to SAVY II (2009) [3]. They have drawn more attention to

the knowledge of adolescents about safe sex and to stress the need for
information about this topic. In Vietnam, with the development of information

technology. adolescents now can easily receive different information about

safe sex. leading to changes in knowledge and attitude.

Therefore,

investigating

knowledge

and

the

needs

of providing

infornntion about reproductive health among adolescents is essential to
provide them with suitable forms and contents. Furthermore, there lias been

no research in Hiep Hoa. Bac Giang - a rural area about this issue. Because of

all reasons above, a thesis named “Knowledge about safe sex and the needs
on providing information on reproductive health among students at the

high school number 2. Hiep Hoa district. Bac Giang province in 2015”
was carried out with two main objectives:

1. To describe knowledge of students aboui safe sex at the high school
number 2 ofHiep Hoa Disrrict, Bac Giang province in 2015.
2. To describe rhe situation and rhe needs ofproviding information on

reproductive health among students at the high school number 2 of
Htep Hoa District, Bat Giangprovince in 20Ì5.

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CHAPTER 1. LITERATURE REMEW
1.1. Definitions and concepts.

l.J.l. Definition of adolescence.
Adolescence is an important stage of life that everyone must be
experienced. It is a transition stage between childhood and adult. According

to WHO. adolescents are young people between the ages of 10 and 19 years

[7]. This stage is marked by physical, mental and social changes, from simple
changes to complex changes. This is a sensitive stage because the physical

condition of adolescents may be completed but about the mental condition,
they are not mature enough and still depend on their parents. At this stage,
they are put under a huge pressure of studying, friendship, reproductive health
and career problems. Especially, at this stage, they have a strong development

of tlieir egos and they are also affected much by the peer

group opinions.

Therefore, they may have many physical, mental and social problems if they

are not oriented by tire adults.
UNICEF has divided adolescence into 2 groups [8]:

Tlte early adolescence (from 10 to 14 years old): Early adolescence
begins with the rapid growth of physical changes and followed by tlie
development of sex organs and reproductive characteristics.

- Tlte late adolescence (from 15 to 19 years old): At this part, the body

is still developing, with a slower speed while the capacity of analytical

and reflective thought is strongly enhanced.

Therefore, the ages of high school children belong to the group of late

adolescence, at which the physical condition is stable, but the psychology
changes strongly.

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1.1 J. Definition of reproductive health
The definition of WHO about ‘“Health” is “A state of complete physical,
social and mental well-being, and not merely the absence of disease or

infirmity” [9].
Following that in 1994. the International Conference of Population and

Development in Cairo. Egypt gave a definition of “Reproductive health".
According to the 1CPD. reproductive health is "A state of complete physical,

mental and social well- being and not merely the absence of disease or
infirmity, in all matters related to the reproductive system and to its function

process. Reproductive health, therefore, implies that people are able to have
satisfying and safe sex life and that they have the capacity to reproduce and

the freedom to decide if. when and how often to do so Implicit in the last
condition are the rights of men and women to be informed and have access to
safe, effective, affordable and acceptable methods of family planning of their
choices, as well as other methods of their choice for regulation of fertility
which are not against the law. the right of access to appropriate health care
senice that women will able to go safety' through pregnancy and childbirth

and provide couples with tire best chance of having a healthy infant" [10].

With this definition, reproductive health consists of 3 main aspects [11]:
Physical condition: A normal reproductive system and a healthy

reproductive function process.

- Mental condition; Satisfying and do not worry about the reproductive
system.

- Social condition: To be respected and behaved fairly about the rights
of sex and reproduction.
In Vietnam reproductive health care had 10 contents. They are;

- Safe motherhood

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- Family planning
- Safe abortion
- Education about reproductive health for adolescents
- Preventing STIs

- Preventing STDs
- Preventing breast cancer and reproductive cancers.
- Infertility
- Sexual health and education about sex

- Information, education and communication about reproductive health

MS. Definition of contraceptive methods
Contraceptive methods are methods used to control fertility and to avoid
unexpected pregnancy. It consists of modern contraceptive methods and

traditional contraceptive methods. Some popular modern contraceptive
methods are condom contraceptive pill (daily and emergency), diaphragm,

vasectomy and tubal ligation. Some popular traditional contraceptive methods

are ovulation calculator, withdrawal and lactation antenorrhea.
1.1.4. Definition of safe sex
Safe sex is tire sexual acts having protected methods to avoid unexpected

pregnancy and STDs, including HIV.AIDS [12].
Unsafe sex is the sexual acts not having protected methods, leading to

unintended pregnancy and contracted to STDs [13].

MS. Contents of reproductive health education among adolescents
Reproductive health education among adolescents consists of several
contents. They are:

- Education about puberty and menstruation.

Education about fertility and contraceptive methods, about condition
and signs of pregnancy.

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- Education about menstrual hygiene and hygiene of reproductive
organs.

- Education about friendship and love, about the risk of the unexpected
pregnancy.

- Education about reproductive health and safe sexual intercourse to

reduce the population burden. STDs, including HIV/AIDS and the
advantages of using condom [11].
1.2. The situation about reproductive health among adolescents
1.2.1. In the world

Over the world, in 2014. there were about 2.5 billton adolescents (under

15 years old), making up about 35% of world population [14]. The situation
about reproductive health among adolescents varies between countries and

religions.
According to a survey conducted in Europe and Uniled Nations, tire

proportion of teenagers who had ever been pregnant were 39.1/1000 women

ages 15-19 in United States (2009). This figure in France (2007) was
7.1/1000, in Germany (2007) was 9.6 1000 and in Netherlands (2006) was
5.3/1000. Also in this survey, in 2007. 14.8/1000 young women from 15-19
years old in United States had abortions [15].

According to UNICEF, among the developing countries (except China),

there were 11 % of females and 6% of males from 15 to 19 years old. who had

sex before 15. Latin America and the Caribbean was the area that had the
highest proportion of female adolescents having sex before 15 years old

(22%). The lowest rate belonged to Asia (15% for both male and female) [8]
In Nairobi, 11% of female students and 50% of male students were

sexually experienced with a significant Jjroportion of students reporting
multiple sexual partnerships. About 40% of sexually experienced female

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srudenis and 65% of sexually experienced male students reported having more
than one sexual partner with 26% of male students having more than five

partners [16].
A research in two universities in Tanzania showed that the majority

(70.4%) of respondents liad sexual intercourse. Among them, more than onethird started sexually activities when they were in secondary school or in the
university and 15.8% of the respondents have had pregnancies and about half

of them had induced abortions [17],
In Thailand, a study showed that 36.5% of female students and 40.7% of
male students had sexual intercourse. Among the 58 female adolescents who

had sexual intercourse. 28 became pregnant (48.3%). Among this number.

50% reported having been pregnant more than once. Fourteen of the 28
female students who got pregnant resorted to abortion (50%) [ I8J.
1.2.2. III t JetII am
In Vietnam, with the decreasing in tire population growth rate and

increasing in the life expectancy, the proportion of people from 10 to 19 years
old fell slightly, comparing to years ago. from 18.7% in 2009 [19] to 15.6%in

2013 [14]. However, reproductive health matters of adolescents in Vietnam
tend to increase.
The Survey Assessment of Vietnamese Youth Round 2 ($AVY H)

showed that 9.5% of respondents reported that they had ever had sex before
marriage, which increased 1.9% comparing to SAVY I. The average age of

first sex tended to decline from 19.6 years old in SAVYI to 18.1 years old in

SAVY II while the singular mean age at marriage tended to increase [3]. (20].

Tliese results obviously demonstrated the number of adolescents having sex

before marriage increased.

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According to Department of Maternal and Child Health, from 2010. the

proportion of adolescents who are pregnant has rose. This rate in 2010. 2011
and 2012 were 2.9%, 3.1% and 3.2% respectively. Following this, tire

propotlion of abortion among this ages were 2.2% (2010). 2.4% (2011) and
2.3% (2012). Although the percentage of abortion in Vietnam is decreasing in

recent 10 years, tins percentage of adolescent tends to be increasing, with
about 20% of the total abortion cases. This rate was highest in Southeast Asia

and the fifth highest in the world [4]. The proportion of adolescents

contracting to HTV/AIDS was 1.8% with under 13 years old groups. 4.11%
with 13 to 19 years old group [6],
1.3. Knowledge of adolescents about safe sex

1.3J. In the world

Mans' researches demonstrated that knowledge about safe sex among

adolescents in the world is still limited, especially in the developing countries
[11(21].
From a research among 253 students in Tanzania, only 24.3% of students

had ever heard about condom, 16.8% had ever heard about contraceptive pill
and 16.5% had ever heard injectable contraceptive method [17],

According to another studs’ among 1440 students from class 6 to 12 in

India, only one-third of male students and one-fourth of female students had
es'er heard about different types of contraception. Two-thirds of respondents

had es’er heaid about HIV. AIDS, and only half of them knew exactly various

ways of transmission HIV [22].
A studs' in Bangladesh, which was conducted in 4 secondary schools,

pointed out that female and male students had poor knowledge about STDs. A
majority of girl only had heard about “sexual diseases”, but did not know
anything about that. All of the respondents recognized AIDS as an STD [23].

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In Tehran, there were nearly 70% of female students who knew that a girl

can be pregnant after having sex for the first time. This rate in males was only
40.6%. Nearly 69% of female students were aware of the protective role of
condoms against HIV and 95% of the adolescent males had heard about STDs

and HIV/AIDS. however, misperceptions were widespread among males [24].

From a study conducted in the slums in Thailand, about 63% of female
adolescents knew about contraceptive pill,

whereas

70.3% of male

adolescents did not know about them. Only 4.4% to 39% of female
adolescents, compared to only 0.8% to 18.6 % of males, knew about

emergency birth control pill, contraceptive injections, implant contraceptives,

intrauterine devices, misoprostol, the fertility awareness method, coitus
interrupts, or vaginal douche [18].
1.3J. In Vietnam
Knowledge about reproductive health among adolescents in Vietnam has

been limited. They still lack basic knowledge about reproductive health issues

[3|.
Most of the adolescents do not know about the time that a girl is easy to
be pregnant. According to SAW II. the percentage of male and female

adolescents who knew exactly about this time was only 7% and 18%

respectively [3]. This rate in Bac Can province was low. only 8.4% of males
and 3.8% of females know about this [25]. From a research among 976

students in Thai Nguyen province. 66 2% of them did not know about the
time that is easy to be pregnant [26Ị. This rate in Ha Nam was lower than
10% for both males and females [27]. Students have mans misconceptions

about fer tility. For example, in Bac Can. more than a half of respondents said
that "Cannot be pregnant if we just have sex once” [25]. Even in the centr e of

Hanoi, there were 36.5% of students had the same opinion [28].

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About different types of contraception, the most common methods that

adolescents knew is condom. Most of the student knew 3 basic methods of

contraception that are condom (93%). contraceptive (91%) and coitus
interrupts (76%) [29]. In a stud}’ carried out in Hoai Due. Hanoi, of 576 high

school students, nearly 70% of them knew about condom, only 59% knew
contraceptive pill and only 39% knew about diaphragm [30]. In Dong Da
District, these rates were 74.2%, 61.s% and 16.6% respectively [28]. In some

studies, knowledge about contraception among adolescents was under

average. In Ho Chi Minh City, about 50% of respondents had right knowledge
about contraception [31 ]. This rate among students in a university in Hue was

only 42.8% [32]. According to SAW n. only 82% of young people claimed
that we should use contraception if we did not want to be pregnant [3].
The number of students answering correctly about the definition of safe

sex varied, from 64.7% in Hanoi to 15.9% in Bac Can [25], [28]. About tlie
consequences of unsafe sex, 83.3% of students knew about unexpected
pregnancy. 74.3% knew about contracted to STDs and 75.6% knew about

suffering from HlV/AIDS [28].

The knowledge of adolescents about STDs is quite good. Three most
popular diseases that they knew were gonorrhea (78%). syphilis (81.6%) and

HIX "AIDS (91.6%) [26], A lower result was found in other research of

Nguyen ThuyNga. About 78.5% of students knew HIX’AIDS. only 50.9%
knew about syphilis and only 29% knew about gonorrhea [28], Students have

best knowledge about HIV. with 95% of respondents could list all the modes
of transmission HIV [3J. However, they still misconceived about the way to
transmit HIX7. Particular!}', tliere were 26% of students who thought tliat one

of the transmissions of HIV was through mosquito bites and 13% of them

thinking that HIX' could ưansmitted by breathing [3].

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Il is seen that there have been “holes” in the knowledge of students about

safe sex. Therefore, they need to be informed about these issues sufficiently

and correctly.
1.4. Information about reproductive health among adolescents.

Í.4./. ĨII the world.
Due to the differences of tradition and religion, adolescents in western

areas are more opened to talk about reproductive to others than adolesceiUs in

other areas, especially in eastern areas and religious areas. However, whether

they discussed this topic or not. they still found information of it from several
sources and by themselves [33].
In Egypt, the adolescents were restricted from reproductive health
education.

Most of them received

little accurate information about

reproductive health. According to a research did in 2009. less than 15% of
males and 5% of females received enough information about the puberty at

school. Tire main sources of reproductive health information that they
received were from mother (about 60% of female), friends (nearly 50% of
males and 25% of female) and relatives (less than 10% of male students) [21Ị.

A research from Nigeria showed tliat more than 73% female students had

ever used the Internet to find the information about reproductive health.

Except the Internet parents and teachers were two main sources of

information with the in-school girls, with 66.22% and 56.15% respectively.
With the out-of -school girls, the main sources of information were friends
(63.18%) [33].
From a study in India, the information sources that adolescents received

most of information about reproductive health were books in school (64.4%).
television (63.8%), teachers (57.3%). The information sources that they
received least information were medical staff (35J%) and radio (21.3%) [22].

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According to a study in New York, half (49%) of adolescents got

infornntion about reproductive health on the Internet. The topics most often
discussed were about sex (42.1%). fitness and exercise (41.6%) and sexual
transmitted diseases (37%) (34].

Ỉ.4.2. Ill ỉĩetiiiun
Vietnam is an eastern country so the discussion about reproductive health

among adolescents and adults is still limited. In recent years, the education

and communication about reproductive health among adolescents has been

more popular.
According to a research in 2012. only 26.1% of female students talked to

their father about the puberty and gender. 18.4% talked to fathers about STDs,
11% talked about sex, and only 7.2% of them talked about contraceptive
methods. Ulis figure in males were 33.6% 25.5%, 12.3%, and 8.9%

respectively [35].
Another research in Ha Tay demonstrated that the mam sources of

information about reproductive health that adolescents can access were

books-'document (70.7%), from school (58.6%). television'movie (41.1%).
Only 33.1% of adolescents received the information from parents and 11.2%

of adolescents received it from medical staff [36]. In Hoai Due District, the
multimedia (television, magazines, radio, the Internet) was the main source of

information about reproductive health, with more than 85% of adolescents

can access. The second source was from medical staff (more than 45% of
adolescents can access) and the last was frail family and friends (more than
20%) [30]

In Ho Chi Minh City, most of adolescents (49.5%) discussed with friends

about reproductive health, love and sex. 36.2% of adolescents discussed with

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parans. 32.4% of Them discovered by themselves. Only 11.3% talked to a
counselor and 43% talked to teachers [37].
When being asked about the need to be informed about reproductive

health, contraception and safe sex. 65.8% of adolescents had demand for this.

People they wanted to share about tins issue were parents (34.3%). counselors
(33.1%) and friends (31.1%) (37). In Phu Tho province, three main sources

that adolescents wanted to receive information from were medical staff
(47.1%), friends (42%) and mother (36.1%) [38]. In another study, the topics

that adolescents wanted to be informed most were HIX’-AIDS (57.6%). STDs
(51.2%), love and marriage (44.5%) [36]. The higher proportion was found in
a research did in Hanoi, with 71.6% of students wanted to be provided

infornntion about reproductive health. Among many topics, they wanted to
know more about love/friendship (58.8%), safe sex (55.9%x STDs (52.4%),

solutions to unexpected pregnancy (50.6%) and contraception (48.9%) [28].

With all tlie results above, there was a high need of providing information
on reproductive health among adolescents. Investigating how this need should
be addressed from perspectives of students and their teachers will help

stakeholders to provide exactly what students want. Having correct
information can protect themselves not only in adolescence but also in tlieir

adulthood.
1.5. The situation of education about reproductive health at the high

school number 2 of Hiep Iloa District

Hiep Hoa District is a midland region in the south - west of Bac Giang
Province. Hiep Hoa is 30 kilometres from Bac Giang city and 50 kilometres
from Hanoi. It is 201 square kilometres in area, with the population in 2009

was 213.200 people.

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The high school number 2 of Hiep Hoa district is one of four high schools

of Hiep Hoa District, which is located in Thang Town. Hiep Hoa District. Bac

Giang province. It lias 36 classes with more than 1500 students and neatly
100 teachers. Recent years, one of the most importaid missions of this school
is to educate about reproductive health but tins mission have not been

completed due to many difficulties. Because of this reason, a research about
knowledge about safe sex and the need to providing information on

reproductive health among students is a necessary and important work that is

encouraged by all of teachers of this school.

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CHAPTER 2. RESEARCH METHODS

2.1. Study setting

The research was carried out at the high school number 2 of Hiep Hoa
District. Bac Giang Province.
2.2. Study population

Students at the high school number 2 of Hiep Hoa district Bac Giang

province.
- Inclusion criteria

4- Students who was studying at their classes when the research was

conducted
4- Students who agreed to participate in tire research.
- Exclusion criteria

4- Students were absent from classes at the time interviews were
carried out

4- Smdents who did not agree to participate in the research.
2.3. Time of study
The study was conducted from October. 2014 to May. 2015. Data was

collected in February and March. 2015.

2.4. Study design
2.4.1. Study design

The study applied quantitative and qualitative research methods.
- Quantitative study: A cross-sectional study, using self-administered

questionnaire.

- Qualitative study: In-depth interviews and focus group discussions were
held after carrying out quantitative study.

2.4 J. Sample size
a) Quantitative study:

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Using fornula for estimating a population proponion with specified
absolute precision

= 7?
p(1”p)
n ■Z«-%
d*
With:

n: Sample size

d= 0.06: /Xbsolute precision required
(1-a): Confident level (95%) -» z = 1.96

p: Anticipated population proponion
According to previous studies:

The proportion of adolescents who had adequate knowledge (including
good and moderate knowledge) about safe sex was 42% [30. 31 [ -> 11 =

260 students

- The proportion of adolescents who had needs of providing information
about reproductive health, was 71.6% [28Ị -> n» 217 students

Choosing bigger sample size with n= 260 students. Because we have 3
clusters (3 grades) with same characteristics, multiplying sample size with

design effect (X2). Finally, the sample size for this study was 260x2=520
students

bi Qualitative study:
The number of students involved in in-depth interviews was increasing
until there was not new information anymore. In reality, there was 10 students
joined in-depth interview.

The number of teacher participating in-depth interviews were 4 teachers
and the number of focus group discussion were 4 groups.

2.43. Sampling method
a) Quantitative study

Using multi-stage sampling method.

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- Stage 1: Choosing classes: Using cluster sampling method

+ Step 1: List all classes
According to the board of president of the high school number 2 of Hiep
Hoa district, there are 42 classes in the school, each grad? has 14 classes, the

number of students in each class ranged from 31 to 45 students.

The average students in each class are 35 students. To have enough
students, the number of classes is 520:35= 14.8 classes (consider as 15
classes)

4- Step 2: Choose classes
Randomly choose 5 classes in each grade from the list.

- Stage 2: Choose students

In each class, choosing all students attending class, having enough

inclusion criteria and agree to join the study.
In reality, a number of students in 15 classes were 642 students.

b) Qualitative study

Using quota purposed sampling method
- For in-depth interviews:

4- Choosing 10 students (5 males and 5 females), who joined the

quantitative study before.
+ Choosing 4 teachers who are teaching Biology and Ethic subject,
which are related to reproductive health issues.

For sycup discussion: 8 students in each group:

+ 2 gr oups of grade 10(1 male and I female group)

+ 2 groups of grade 11 (1 male and I female group)

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