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Nguyen AD, Nguyen LH, Nguyen LD, Ninh LT, Nguyen HTT, Nguyen CT, Nathan N, Do AL, Le AM, Doan LP, Nguyen SH, Vu TMT, Tran BX, Latkin CA, Ho CSH, Ho RCM. Toward sustainable development goals in gender inequality: an analysis of gender preferences among urban pregnant women in a Southeast Asian country. BMC Pregnancy Childbirth 2023; 23:780. [PMID: 37950212 PMCID: PMC10638686 DOI: 10.1186/s12884-023-06109-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 11/04/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Gender-biased discrimination and preferences are global phenomena, particularly son preferences. However, updated evidence about this issue in Vietnam has not yet been provided. Therefore, this study aimed to examine the gender preferences among pregnant women and identify associated factors of such preferences. METHODS A cross-sectional survey was conducted in two hospitals in Vietnam with 732 pregnant women. Gender preferences for their child were asked, along with socio-demographic (e.g., education, occupation) and pregnancy characteristics (e.g., pressure to have a son, gender of first child, the importance to have a son of family members, and information sources on pregnancy care) by using face-to-face interviews and a structured questionnaire. Multinomial logistic regression was performed to determine factors associated with gender preferences. RESULTS About 51.9% of the participants had no gender preference, while, among those who had a gender preference, 26.5% preferred sons, and 21.6% preferred daughters. Only 6.2% had pressure to have a son. Having the first child who was female (OR = 4.16, 95%CI = 1.54-11.25), having the pressure to have a son (OR = 6.77, 95%CI = 2.06-22.26), and higher self-perceived importance to have a son (OR = 3.05, 95%CI = 1.85-5.02) were positively associated with son preference. Otherwise, women having partners with high school education or above (OR = 2.04, 95%CI = 1.06-3.91), living with parents-in-law (OR = 2.33; 95%CI = 1.25-4.34), the higher number of pregnancies, and a higher degree of importance in having a son regarding parents-in-law (OR = 2.15, 95%CI = 1.38-3.35) associated with higher odds of preferring daughter. CONCLUSION This study showed that gender preference was common among pregnant women, but the pressure to have a son was low. Further education programs and legal institutions should be implemented to improve gender inequality and gender preference in society.
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Affiliation(s)
- Anh Duy Nguyen
- Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam
| | - Long Hoang Nguyen
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Lam Duc Nguyen
- Department of Anesthesiology, Hanoi Medical University, Hanoi, Vietnam
| | - Ly Thi Ninh
- Social Affair Department, Ca Mau Obstetrics & Pediatrics Hospital, Ca Mau, Vietnam
| | | | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, 550000, Vietnam.
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam.
| | - Nila Nathan
- Quantitative Biomedical Sciences, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
| | - Anh Linh Do
- Institute of Health Economics and Technology, Hanoi, Vietnam
| | - Anh Minh Le
- Institute of Health Economics and Technology, Hanoi, Vietnam
| | - Linh Phuong Doan
- Institute for Global Health Innovations, Duy Tan University, Da Nang, 550000, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Son Hoang Nguyen
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, 700000, Vietnam
| | | | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Cyrus S H Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
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Kalra H, Tran TD, Romero L, Chandra P, Fisher J. Prevalence and determinants of antenatal common mental disorders among women in India: a systematic review and meta-analysis. Arch Womens Ment Health 2021; 24:29-53. [PMID: 32055988 DOI: 10.1007/s00737-020-01024-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 01/26/2020] [Indexed: 02/06/2023]
Abstract
To review the available evidence about the prevalence and determinants of antenatal common mental disorders (antenatal CMDs) among women in India. We searched Ovid Medline, Embase and Psyinfo systematically from date of inception to Oct. 31, 2019 for publications in English language on the prevalence of antenatal CMDs and their determinants among women in India. All study designs were included. Quality was assessed with Standard Quality Assessment Criteria for Evaluating Primary Research Papers. We performed a meta-analysis using a random effects model. Twenty-seven studies involving 7780 women were analysed. There was a high degree of heterogeneity ((I2 = 97.53%). Publication bias [Egger bias = 0.65 (95% CI: 0.36; .94)] was evident. The overall pooled estimate of the prevalence of antenatal CMDs was 21.87% (95% CI: 17.46; 26.29). Significant risk factors reported in the 18 studies which examined them were negative reaction of husband or in-laws to the dowry, difficult relationship with husband/in-laws, lack of support or experiencing violence perpetrated by an intimate partner and preference for or feeling pressured to have a male child. Protective factors were having more education and being employed, having a supportive husband and opportunities for recreation during pregnancy. Antenatal CMDs are highly prevalent among women in India. There is an urgent need for locally developed policies and programmes for mental health promotion during pregnancy, preventive and early intervention for antenatal CMDs among women to be integrated into maternity care in India.
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Affiliation(s)
- Harish Kalra
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, 3004, Melbourne, VIC, Australia. .,Ballarat Rural Clinical School, University of Notre Dame Australia, 01 Drummond St Nth, 3350, Ballarat Central, VIC, Australia. .,Raphael Services, Ballarat, St John of God Health Care Social Outreach, 105 Webster St, 3350, Ballarat Central, VIC, Australia. .,Ballarat Health Services-Mental Health Services, Sturt St, 3350, Ballarat Central, VIC, Australia.
| | - Thach Duc Tran
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, 3004, Melbourne, VIC, Australia
| | - Lorena Romero
- The Ian Potter Library, The Alfred Hospital, 55 Commercial Rd, 3004, Melbourne, VIC, Australia
| | - Prabha Chandra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru, 560029, Karnataka, India
| | - Jane Fisher
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, 3004, Melbourne, VIC, Australia
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Bhushan NL, Krupp K, Jaykrishna P, Ravi K, Khan A, Shidhaye R, Kiplagat S, Srinivas V, Madhivanan P. The association between social support through contacts with Accredited Social Health Activists (ASHAs) and antenatal anxiety among women in Mysore, India: a cross-sectional study. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1323-1333. [PMID: 32146484 PMCID: PMC7483323 DOI: 10.1007/s00127-020-01854-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 02/28/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE In India, antenatal anxiety prevalence estimates range from 6 to 48%. Social support is strongly associated with mental wellbeing, yet most studies have examined the impact of support from partners and family members rather than peers, community members, or health care providers. This study explores the supportive role of Accredited Social Health Activists (ASHA) contacts for antenatal anxiety. METHODS Data were analyzed from the Saving Children, Improving Lives project, a quasi-experimental study conducted among rural, pregnant women in India. Regression models were used to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals for the relationship frequency of ASHA contacts and antenatal anxiety. Antenatal anxiety was measured using a subscale of the Edinburgh Postnatal Depression Scale. RESULTS The sample consisted of 480 pregnant women. Reported antenatal anxiety prevalence was 27% (95% CI 23%, 31%). Participants who were more frequently visited by ASHAs at home (aPR: 0.90; 95% CI 0.76, 0.98) and more frequently accompanied by ASHAs to their antenatal care visits (aPR: 0.86, 95% CI 0.78, 0.95) were less likely to report antenatal anxiety. ASHA home visits were protective for the most vulnerable women (primigravida and those experiencing domestic violence) and ASHA accompaniment to antenatal care visits was equally protective for all women. CONCLUSIONS ASHAs are valued for their contribution towards maternal health education and linking women of reproductive age to healthcare services. Our findings additionally suggest the important role ASHAs play in providing social support to pregnant women, particularly those who are most vulnerable to experiencing antenatal anxiety.
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Affiliation(s)
- Nivedita L. Bhushan
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Karl Krupp
- Public Health Research Institute of India, Mysore, Karnataka, India,Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | | | - Kavitha Ravi
- Public Health Research Institute of India, Mysore, Karnataka, India
| | - Anisa Khan
- Public Health Research Institute of India, Mysore, Karnataka, India
| | - Rahul Shidhaye
- Pravara Institute of Medical Sciences, Loni, Maharashtra, India
| | | | - Vijaya Srinivas
- Public Health Research Institute of India, Mysore, Karnataka, India
| | - Purnima Madhivanan
- Public Health Research Institute of India, Mysore, Karnataka, India,Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA,Division of Infectious Diseases & Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, Arizona, USA
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