title: Perspectives of midwives and doctors on adolescent sexuality and abortion care in Vietnam.
abstract: BACKGROUND
  Vietnam has one of the highest abortion rates in the world and adolescent abortions are thought to constitute at least one-third of all cases. Lack of balanced reproductive health information and services to adolescents and negative social attitudes towards adolescent sexuality are contributing factors to the high abortion rates. Health providers are important in guiding and counselling adolescents on how to protect their reproductive health. There is a lack of studies on health providers' perspectives on their work in adolescent reproductive health care.
  
  
  OBJECTIVE
  To explore the perspectives of midwives and doctors on adolescent sexuality and abortion, and what they considered to be quality abortion care for adolescents and the barriers to it, as well as to their own training needs.
  
  
  METHODS
  Observations of care in abortion clinics and focus-group discussions (FGD) were used to collect data. Doctors and midwives from three healthcare facilities in Quang Ninh province in Northern Vietnam participated in a total of eight FGDs. Data were analysed using latent content analysis.
  
  
  RESULTS
  Major barriers identified for quality abortion care were of technical and managerial nature. Participants considered that counselling unmarried clients in connection with abortion should focus on warning against the risks and dangers of abortion and pre-marital sexual relations, which they strongly disapproved of. However, they also expressed a pragmatic and caring attitude towards the unmarried girls and couples coming for abortion. Adolescent sexuality and abortion are morally sensitive issues in the Vietnamese culture. The contradictions between cultural norms and the reality facing health providers while counselling unmarried adolescents need to be addressed in education and training programmes.
authors.affiliation: Department of Public Health Sciences, Division of International Health (IHCAR), Karolinska Institutet, Sweden. marie.klingberg@phs.ki.se
authors.forename: Marie
authors.initials: M
authors.lastname: Klingberg-Allvin
authors.forename: Nguyen Thu
authors.initials: NT
authors.lastname: Nga
authors.forename: Anna-Berit
authors.initials: AB
authors.lastname: Ransjö-Arvidson
authors.forename: Annika
authors.initials: A
authors.lastname: Johansson
mesh_terms: D000028:Abortion, Induced / Q000451:nursing / Q000523:psychology / Q000592:standards / Q000706:statistics & numerical data; D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D001291:Attitude of Health Personnel; D003376:Counseling; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D009721:Nurse Midwives / Q000193:education / Q000523:psychology; D010820:Physicians / Q000523:psychology; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000523:psychology / Q000706:statistics & numerical data; D011361:Professional Competence; D011369:Professional-Patient Relations; D012307:Risk Factors; D012736:Sex Education; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D014744:Vietnam