Pregnant Adolescents in Vietnam : Social context and health care needs

Background: The number of childbearing adolescents in Vietnam is relatively low but they are more prone to experience adverse outcome than adult women. Reports of increasing rates of abortion and prevalence of STIs including HIV among youth indicate a need to improve services and counselling for these groups. Midwives are key persons in the promotion of young people’s sexual and reproductive health in Vietnam. Aim: The overall aim of this thesis is to describe the prevalence and outcome of adolescent pregnancies in Vietnam (I), to explore the social context and health care seeking behavior of pregnant adolescents (II), as well as to explore the perspectives of health care providers and midwifery students regarding adolescent sexuality and reproductive health service needs (III, IV). Methods: The studies were conducted from 2002 to 2005, combining qualitative and quantitative research methods. A population based prospective survey was used to estimate rates and outcomes of adolescent pregnancies (I). Pregnant and newly delivered adolescents’ experiences of childbearing and their encounters with health care providers were studied using qualitative interviews (II). Health care providers’ perspective on adolescent sexual and reproductive health (ASRH) and views on how to improve the quality of abortion care was explored in focus group discussions (FGD). The values and attitudes of midwifery students about ASRH were investigated using questionnaires and interviews (IV). Descriptive statistics was used to analyse quantitative data (I, IV) and content analysis were applied for qualitative data (II, III, and IV). Findings: Adolescent birth rate was similar to previously reported in Vietnam but lower when compared to other Asian countries. The incidence of stillborn among adolescents was higher than for women in higher reproductive ages. The proportion of preterm deliveries was 20 % of all births, higher than previous findings from Vietnam. About 2 % of the deliveries were home deliveries, more common among women with low education, belonging to ethnic minority and/or living in mountainous areas (I). Ambivalence facing motherhood, pride and happiness but also worries and lack of self-confidence emerged as themes from the interviews; and experience of ‘being in the hands of others’ in a positive, caring sense but also in a sense of subordination in relation to husband, family and health care providers (II). Health care providers at abortion clinics and midwifery students generally disapproved of pre-marital sex, but had a pragmatic view on the need for contraceptive services and counselling to reduce the burden of unwanted pregnancies and abortions for young women. Providers and midwifery students expressed a need for training on ASRH issues (III, IV). Conclusion: Cultural norms and gender inequity make pregnant adolescent women in Vietnam vulnerable to sexual and reproductive health risks. Health care providers experience ethical dilemmas while counselling unmarried adolescents who come for abortion and this has a negative impact on the quality of care. Integrated ASRH in education and training programmes for health care providers, including midwives, as well as continued in-service training on these issues are suggested to improve reproductive health care services in Vietnam.

Parenthood in transition : Somali-born parents' experiences of and needs for parenting support programmes

BACKGROUND: Pre- and post-migration trauma due to forced migration may impact negatively on parents' ability to care for their children. Little qualitative work has examined Somali-born refugees' experiences. The aim of this study is to explore Somali-born refugees' experiences and challenges of being parents in Sweden, and the support they need in their parenting. METHODS: A qualitative descriptive study was undertaken. Data were collected from four focus group discussions (FGDs) among 23 Somali-born mothers and fathers living in a county in central Sweden. Qualitative content analysis has been applied. RESULTS: A main category, Parenthood in Transition, emerged as a description of a process of parenthood in transition. Two generic categories were identified: Challenges, and Improved parenting. Challenges emerged from leaving the home country and being new and feeling alienated in the new country. In Improved parenting, an awareness of opportunities in the new country and ways to improve their parenting was described, which includes how to improve their communication and relationship with their children. The parents described a need for information on how to culturally adapt their parenting and obtain support from the authorities. CONCLUSIONS: Parents experienced a process of parenthood in transition. They were looking to the future and for ways to improve their parenting. Schools and social services can overcome barriers that prevent lack of knowledge about the new country's systems related to parenthood. Leaving the home country often means separation from the family and losing the social network. We suggest that staff in schools and social services offer parent training classes for these parents throughout their children's childhood, with benefits for the child and family.

Interesses da habitação social : políticas e processos no Rio Grande do Norte

En 2003, le gouvernement brésilien (gestion Lula) a initié une nouvelle phase dans son histoire de l habitation, en intensifiant les constructions de logements sociaux au Brésil. Un tel accroissement a eut des répercussions tant en ville comme à la campagne, et fût marqué dans le Rio Grande do Norte, par la production a grande échelle d ensembles d habitations, dans les programmes de Gouvernement. Afin de viabiliser ces transformations, des instruments politiques, financiers et de gestion ont étés articulés conjointement, utilisant la répétition d une typologie d édification, comme modèle, accompagnée de la reproduction d une morphologie dans les constructions de logements sociaux. Afin de comprendre ce processus nous introduisons une recherche urbanistique et socio-économique du problème du logement social au Brésil, en cherchant à mettre en relation les aspects techniques avec les questions historique, professionnelles et culturelles, éléments complémentaires. Notre analyse cherche a identifier comment les politiques de gestion et financement officielles (administrées dans sa grande majorité par la Caisse Économique Fédérale -CEF-), influencent le processus de conception de projets, en provoquant les répétitions de type/morphologiques, déjà citées. Basée sur l observation directe au cour de deux expériences différenciées pour du logement social en milieu rural, au Rio Grande do Norte, nous montrerons aussi certaines limitations et possibilités des acteurs sociaux, face aux agents et politiques officielles pour le logement social au Brésil, proposant des solutions alternatives standardisées qui caractérisent le résultat des projets financées et gérés par la CEF. Nos principales références théoriques et méthodologiques sont Nabil Bonduki (1998), David Harvey (2009,1982), Henry Lefèbvre (1970), Ermínia Maricato (2010, 2009, 2000, 1987) et Raquel Rolnik (2010, 2009, 2008, 1997)

Quem tem direito à moradia? :uma análise da política nacional de habitação e dos programas de habitação de interesse social (2003-2005)

This dissertation analyses the Brazilian housing policy of today s, focusing on the programmes in the socalled Social Interest Housing Subsystem in order to discuss to what extent the government has been able to grant housing constitutional rights in the country. The discussion is about housing policy and the principles in the country s Constitution regarding the role of housing as a social right, a right that must be granted by the state. This refers to land rent theory to understand the relationship between capital and property and the reasons why, under capitalism, housing becomes a commodity in the market. Then, it discusses the national housing policy, which emphasizes land ownership through financing, that is, via market, a process that excludes all low income population. In the conclusion, it is clear that, although government programmes cover extensively at least potentially the national territory as well as social group, subsidized housing programmes cannot be implemented in the city due to land prices because subsidy is too low. In this way, the law that grants housing rights to all Brazilian citizens is violated

Social Panorama of Latin America 2001-2002

Includes bibliography

Social Panorama of Latin America 2004

Includes bibliography

Social Panorama of Latin America 2005

Includes bibliography

Social Panorama of Latin America 2006

Includes bibliography

Social Panorama of Latin America 2009

Includes bibliography

Youth and social cohesion in Ibero-America: a model in the making. Summary

Includes bibliography

Review of Caribbean economic and social performance in the 1980's and 1990's

Includes bibliography

Shaping the future of social protection: access, financing and solidarity

Includes bibliography

Social dimensions of macroeconomic policy: report of the Executive Committee on Economic and Social Affairs of the United Nations

Introduction The social agenda is long-term in nature, in the sense that poverty alleviation along with a better distribution of income, wealth and opportunities are long-term goals. A sound macroeconomic policy, on the other hand, has to do largely with the consistent management of short-term policy instruments pursuing a sustainable and predictable pace for aggregate economic variables and major prices (wages, inflation, interest rates and exchange rates). In spite of the different arena and rationale in which they play, there are strong links between the two. First and most obvious, macroeconomic adjustment and structural reform are more likely to be sustainable when they are equitable. Second, social intervention —i.e., policies, programmes and reforms aimed at improving social performance in the long run—, needs stable funding which is not always available in view of macroeconomic constraints. Third, macroeconomic instability —especially episodes of recession or hyperinflation— increases poverty and inequality, while restoring macroeconomic equilibrium does not restore previous social balances. Finally, there is no unique macroeconomic policy mix to tackle a given situation, and the policy options may not be neutral from a social standpoint. Monetary, fiscal and exchange rate policies, together with structural reform, have major consequences for the social wellbeing of societies, not only in terms of protection against shocks and crises but also in terms of equity. Many, if not all, of the necessary social policies are of a domestic nature. This report thus concentrates on domestic strategies aimed at maximizing the linkages between consistent macroeconomic policies and social progress. Pursuing them, however, depends to a considerable extent on the international enabling environment in which the global financial system, the unsettled debt crisis and increasing ODA flows play a significant role. Countries operate in a world economy where market players everywhere immediately scrutinize domestic monetary, financial or fiscal policy decisions and the performance of exchange rate regimes of individual countries. Under these conditions, the room for manoeuvre of policymakers has become considerably constrained. Consequently, it is becoming increasingly complex to incorporate the social dimensions into such policy decisions, to the extent that external analysts consider that authorities are sacrificing sound macroeconomic policies. The main message of the report is that the expediency of short-term economic efficiency as embedded in much of the advice on macroeconomic stability needs to be tempered by long-term development objectives. The report starts with a short historical background which describes the ascendancy of macroeconomic policies over social development policies (chapter I). It continues with an evaluation of the relation between macroeconomic consistency and social effort (chapter II), and the importance of sustainable and stable growth for social progress (chapter III). The report then turns to the need for an equity-enhancing growth strategy (chapter IV) and an analysis of the priorities of social policies in an integrated approach to growth (chapter V). The final chapter adds some final institutional remarks.

Social protection for the poor in Latin America

Includes bibliography

Fiscal policy and social protection

Includes bibliography