Suchergebnisse

AbstractSocial and economic changes in Vietnam since the economic restructuring of the 1980s have caused a shift in norms about premarital sex. While expectations of female chastity remain, sex before marriage is becoming more common among young people. As the formative phase of a parent randomized controlled trial, the present study examined the normative context of sex in dating relationships from the perspectives of young women and men in Vietnam. Men (n = 12) and women (n = 9) studying at two universities in Hanoi participated in semi-structured interviews that explored perspectives on sexual relationships and sexual coercion among their peers. Thematic analysis synthesized participant narratives into broader themes. Our findings confirmed that, as social norms evolve in Vietnam, young women must navigate shifting, and often contradictory, expectations about sex and dating relationships. Women and men expressed the belief that competing sexual expectations often can limit young women's sexual agency and contribute to the normalization of sexual coercion in dating relationships. However, some women were embracing greater sexual freedom and reframing norms in ways that reflected their sexual agency. Efforts are needed to address these conflicting expectations, to deepen young men's understanding of this conflict, and to prevent sexual coercion in young adulthood.

BACKGROUND: Maternal immunization is a key strategy for reducing morbidity and mortality associated with infectious diseases in mothers and their newborns. Recent developments in the science and safety of maternal vaccinations have made possible development of new maternal vaccines ready for introduction in low- and middle-income countries. Decisions at the policy level remain the entry point for maternal immunization programs. We describe the policy and decision-making process in Kenya for the introduction of new vaccines, with particular emphasis on maternal vaccines, and identify opportunities to improve vaccine policy formulation and implementation process. METHODS: We conducted 29 formal interviews with government officials and policy makers, including high-level officials at the Kenya National Immunization Technical Advisory Group, and Ministry of Health officials at national and county levels. All interviews were recorded and transcribed. We analyzed the qualitative data using NVivo 11.0 software. RESULTS: All key informants understood the vaccine policy formulation and implementation processes, although national officials appeared more informed compared to county officials. County officials reported feeling left out of policy development. The recent health system decentralization had both positive and negative impacts on the policy process; however, the negative impacts outweighed the positive impacts. Other factors outside vaccine policy environment such as rumours, sociocultural practices, and anti-vaccine campaigns influenced the policy development and implementation process. CONCLUSIONS: Public policy development process is complex and multifaceted by its nature. As Kenya prepares for introduction of other maternal vaccines, it is important that the identified policy gaps and challenges are addressed. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13012-021-01101-7.