TAP CHi Y OaOC LAM S A N G 108 Tap 9 - S6 1/2014
Nghien cu-u kign thirc, thai do, thyc hanh lua chon gioi tinh thai nhi ciia cac cap vff chong 6* tinh BSc Giang
A Study on the Knowledge, Attitude and Practice of Fetal Sex Selection of Couples in Bac Giang Province
Han Thj H6ng Thuy*; Le Van Bao**; *Sa Yti Bdc Giang Hoang Hai^* .. ^ . ^
**Hqc vien Quan Y
Muc tieu nghien cdu: Md ta thdc trang kien thdc, thai do, thuc hanh Ida chon gidi tinh thai nhi (LCGTTN) cua cac cap va chdng sinh con d tinh Bac Giang. Do; ruong.-1 164 cap va chdng smh con trong 5 nam (tUthang 01/2007-12/2011), tai 3 huyen dai dien cho 3 viing cd ty so gidi tfnh khi smh (TSGTKS) cao cua tinh Bac Giang: Luc Nam, Lang Giang va Viet Yen. Phuang phap- Nghien cdu md ta ngang (tien cdu, hdi cdu)./<efqud;(l) Kien thdc: t y l e ddi tupng biet hau quaxa hpi cua lUa chon gidi tinh thai nhi cdn han che (83,6% biet se gay thda nam, thieu nd va 12,6% cho rang khdng anh hudng gi den xa hdi); trong khi, cd 28% biet cac bien phap lUa chpn gidi tfnh thai nhi; (2) Thai do. Ty le doi tuang mong muon cd con trai chiem ty cao (54,6%); (3) ThUc hanh: Ty le cac cap vO chong lUa chon gidi tinh thai nhi trong lan smh tiep theo la kha cao (18,0%).
Ti/khda: Kien thUc, thai do, thuc hanh, lUa chon gidi tfnh thai nhi, BSc Giang
Summary
Research Aims: To describe the knowledge, attitude and practice of fetal sex selection of couples in Bac Giang Province Objectives: 1,164 couples giving birth for 5 years, (from the beginning of January 2007 to the end of December 2011), in 3 districts with high sex ratio at birth in Bac Giang Province, namely, Luc Nam, Lang Giang and Viet Yen Methods- A horizontal (prospective, retrospective) description study. Results: (1) Knowledge' The knowledge of objectives about sociai influences of fetal sex selection is limited (83.6% know that it leads to having more boys than girls; 12.6% think that it has no influence on the society), while 28% know about fetal sex selection methods; (2) Attitude: A high ratio of objectives want to have a boy baby (54.6%); (3) Practice: A high ratio of objectives utilize the fetal sex selection methods in next birth delivery (18.0%)
Keywords. Knowledge, Attitude, Practice, Fetal sex selection, Bac Giang
I.Datvande khoang 1 diem phan tram (diem %) mdi nam, gap ddi tdc dp gia tang d m o t sd qudc gia Chau A khac Trong 5 nam gan day, ty sd gidi tinh khi sinh
(TSGTKS) d Viet Nam ndi chung va tinh Bac Giang ndi rieng cd xu h u d n g tang nhanh han, binh quan
Pliiiri bipn khoa hpc: TS. DO HOA BINH
nhd: Han Qudc, Trung Qudc, An Od. D d bao trong thdi gian t d i , TSGTKS d Viet Nam cdn tiep tuc tang do tinh trang Ida chon gidi t i n h thai nhi (LCGTTN) ngay cang lan rdng [1], [5], [6].
JOURNAL OF 108 - CLINICAL MEDICINE AND PHARMACY Vol9-N°1/20H
Ket qua Tdng dieu tra dan so va nha d nam 2009 cho thay. TSGTKS t i n h Bae Giang la 116,8 nam/100 nd, cao han so vdi binh q u a n ehung ca nUdc (110,5/100), dupc xep vao t d p 10 t r o n g sd 63 t i n h / t h a n h phd cd TSGTKS cao nhat, sau d o van tiep tuc tang khdng ngUng vdi toe do nhanh [4],
Neu t i n h trang nay van tiep tuc keo dai, khdng cd sd can thiep manh me thi se gay he luy nhieu mat den su phat trien kinh te - xa hdi cua t i n h Bac Giang ndi rieng va ca nudc ndi ehung. fviuc tieu cua nghien cdu: "Md td thuc trgng kien thUc, thdi do, thuc hdnh LCGTTN cda cdc cap vg chong sinh con d Bdc Giang".
2. Ddi tUdng va phUcrng phap nghien cuTu 2.1. Doi tupng, tbcfi gian nghiin cUu
1.164 cap vo chdng sinh con t r o n g t h d i gian tU thang 01/2007 den het t h a n g 12/2011, tai 3 huyen:
Luc Nam (387 ddi tUdng); Lang Giang (387 ddi tuong); Viet Yen (390 ddi tUpng).
2.2. Phuang phap nghiin cUu
- Thiet ke nghien cdu m d ta cat ngang, tien cdu, hoi cdu.
- Cd mau nghien edu: Ap d u n g cdng thdc:
d- Trongdd: n: ed mau nghien eUu (cap v a chdng)
a : m U c y n g h T a [a =0,05), Z = 1,96 3. Ket qua nghien cuti
p = 84,0% la t y ie cac cap vd/chdng biet hSu quj ddi vdi xa hdi eua lua chpn gidi tinh thai nhi se gay thda nam, thieu n d (Ket qua dieu tra thCr cOa c h u n g ^ trudc khi dieu tra chinh thdc t r o n g nghien cdu nay).
d: mdc d p c h i n h xac ky v p n g (0,05).
Thay so, t i n h t o a n dugc n=1.164 cap v d chong, - Chpn mau: Chon sd Iddng cap vo chdng is 3 huyen theo phUdng phap phan tang khdng can xijlng (1.164 cap vo chdng: 3 huyen). Ket qua cu the: Luc Nam: 387, Lang Giang: 387 va Viet Yen: 390). Moi huyen chpn 2 dan vj hanh chinh (1 xa va 1 thj tran co TSGTKS cao), lap danh sach ten ngUdi v d cua cac cap v a ehdng sinh con t U 01/2007 den 12/2011 theo van bang c h d cai A, B, C... va tien hanh chpn ddi tugng cu the theo p h d d n g phap ngSu nhien he thdng.
- PhUdng phap t h u t h a p sd lieu: Phdng van cac ddi t u g n g nghien cdu bang bp cau hdi thiet ke san;
phan tich sd lieu t h d cap.
- Bien sd nghien cUu:
+ Bien sd ve kien thdc; Ty le ddi tUdng biet cac bien phap LCGTTN; n h d n g bien phap thudng ap d y n g de LCGTTN; anh hUdng cua LCGTTN.
-I- Bien ve thai d o : DU d i n h sinh them con va m o n g m u d n gidi t i n h dda eon d lan sinh tiep theo.
-!- Bien sd thUc hanh: Ty le ddi tUdng LCGTTW t r o n g lan sinh gan nhat.
- So lieu duac phan tich bang phan mem EpI info 6.04.
3.1. Kien thUc ve lUa chpn gidi tinh thai nhi
Bang 3 . 1 . Ty le ddi tUdng biet cac bien p h a p LCGTTN ( n = l .164)
Bien so
Biet Khong bieT Khong tra Idi
Luc Nam SL 142 117 128
%
36,7 30,2 33,1
Lang Giang SL 136 123 128
%
35,1 31,8 33,1
Viet Yen SL 48 96 246
%
12,3 24,6 63,1
Ch SL 326 336 502
j n g
%
28,0 28,9 43,1 Ty le doi tirong biet cac bien phap co t h e ap biet bien phap nao {28,?
d u n g de LCGTTN la 28,0%; d Luc Nam (36,7%) va kha cao (43,1%).
Lang Giang (35,1%) cao hon Viet Yen (12,3%); khong
o); k h o n g tra Idi chiem tyle
TAP CHl Y DUOC LAM SANG 108
Bang 3.2. Ty le doi t u g n g biet
Bien phap ap dung Sieu am, nao pha thai Tinh ngay gid Theo kinh nghiem Tif vi, cau thanh than Che do an Khac
Luc Nam SL 83 48 53 7 43 44
%
21,4 12,4 13,7 1,8 11,1 11,4
T9p9-561/2014
cac bien phap de LCGTTN (n=1.164) Lang Giang
SL 27 32 9 9 46 24
%
7,0 8,3 2,3 2,3 1,9 6,2
Viet Yen SL 27 18 16 5 15 12
%
6,9 4,6 4,1 1,3 3,8 3,1
Chung SL 137 98 78 21 104 80
%
11,8 8,4 6,7 1,8 8,9 6,9 Cac bien phap doi t u o n g t h a d n g ap d u n g de LCGTTN; sieu am tfnh ngay rung trufng, sieu am biet GTTN va nao pha thai LCGT(11,8%), cao nhat la d Luc Nam 21,4%; t i n h ngay g i d de quan he v g chong (8,4%); theo kinh nhiem cua nhCfng ngudi da cd con trai (6,7%); thac hien che do an (8,9%); cac bien phap khac (7,8%).
Bang 3.3. Kien thufc cua doi tuong ve anh hadng cua LCGTTN (n=1.164) Cac anh hudng
(hau qua) Khdng anh hudng gi Gay thira nam, thieu nCf Khd lay vg (ddi vdi nam) Y kien khac
Luc Nam SL 62 315 217 1
%
16,0 81,4 56,1 0,3
Lang Giang SL 62 313 159 1
%
16,0 80,9 41,1 0,3
Viet Yen SL 23 345 302 4
%
5,9 88,5 77,4 1,0
Chung SL 147 973 678 6
%
12,6 83,6 58,2 0,5 Anh hudng cua LCGTTN: Khdng Snh hddng den xa hdi (12,6%), Luc Nam va Lang Giang (16,0%) cao hdn Viet Yen (5,9%); nguy co xay ra hien t d d n g thUa nam, thieu n d (83,2%); nguy co xay ra tinh trang nhieu nam gidi khdng lay duac v a (58,2%); cae y kien khac (0,5%).
3.2. Thii dp ve lUa ehpn gicfi tinh thai nhi
Bang 3.4. D U d m h sinh them con va mong muon gidi tinh dda con lan sinh tiep theo ( n = l .164)
D u d i n h / m o n g mudn C d d u d i n h
-Tra;
-Gal -Traihodc gdi
- Khdng biet/
Khdng tra Idi Khong d u dinh
Khdng tra Idi
Luc Nam SL 218 109 60 49 0
160 9
%
56,3 50,0.
27,5 22,5 0,0
41,3 2,3
Lang Giang SL 130 85 23 22 0
254 3
%
33,6 65,4 17,7 16,9 0,0
65,6 0,8
Viet Yen SL 168 88 35 42 3
221 1
%
43,1 52,4 20,8 25,0 1,8 56,7 0,3
Chung SL 516 282 118 113 3 635
13 44,3
%
54,6 22,9 21,9 0,6
54,6 1,1 Trong so doi tupng nghien cilu, cd 516 ngudi (44,3%) cd dU djnh smh them con; trdng dd, Co 282 nguoi (54,6%) mong muon gidi tinh dda con tiep theo la trai; 118 ngUdi (22,9%) mong con gai; 113 ngudi (21,9%) khdng quan trpng con trai hay gai.
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JOURNAL OF 108 - CLINICAL MEDICINE AND PHARMACY Voi 9 - N°1/2014
3.3. Thuc binh lua chpn gidi tfnh thai nhi
KTL (9.5%)^ Co (18.0%)
Khong (72.0%)
Bii'u do 3.1. Ty le doi tuong LCGTTN trong lan sinh gdn nhdt (n= 1.164)
Trong lan smh gan nhat: 210 ngUdi (18%) tra Idi la cd LCGTTN; 110 ngddi (9,5%) khdng tra Idi (KTL) khi phdng van.
4. Ban luan
4.1. Ve kii'n thUe lUa chpn gidi tinh thai nhi
1.164 ddi t u p n g dUde Ida chon tai 03 huyen (dai dien cho mien nui; t r u n g d u ; va d d n g bang) cua Tinh B k Giang da cho ket qua nhU: ty le ddi t u a n g biet cac bien phap cd the ap d y n g de LCGTTN ia 28,0%, trong thdc te ed the cdn cao hon (vi ed 4 3 , 1 % ngudi khdng tra Idi, ed the do e ngai hay ne tranh, do cd the ho biet viec LCGTTN bj phap luat earn.
Khi biet duac nhUng bien phap t h u d n g ap d u n g de LCGTTN, cac ddi tUang se t i m den cac dich vu hd tro rat san cd d dia p h d d n g de ed dddc ket qua sinh con theo y m u o n . Tmh trang nay t h u c day gia tang ty le nao pha thai va nhU vay se dan den viec lam mat can bang TSGTKS.
Cdn m d t sd lUdng khdng nhd doi tUOng chua nhan thdc day du ve anh hUdng cua LCGTTN (12,6%
cho la LCGTTN khdng anh hUdng gi ddi vdi xa hdi), nhdng ddi t u o n g nay cd t h e cd n h d n g hanh vi thieu trach nhiem, ho se la ngUdi trUc tiep LCGTTN hoac tuyen truyen van d p n g ngUdi khae t h a m gia LCGTTN, ty le cac ddi t u a n g hieu dugc anh h u d n g kl-rac cua LCGTTN ehi cd 0,5%, cho thay nhiem vu cong tac tuyen truyen cdn rat nang ne, dae biet la nhdng huyen nhULuc Nam, Lang Giang.
4.2. Ve thai dp lUa chpn gidi tinh thai nhi
Trong sd 516 doi t u a n g (44,3%) cd d d d i n h sinh t h e m con. cd 282 ngddi (54,6%) m o n g muon giai t i n h cua con d lan smh t i e p theo !a trai, ket qua t u o n g ddi d o n g deu d eae huyen nghien cUu; l<et qua nghien cdu nay thap han ket qua nghien cu'u cua Hoang Thj Khuyen d Hdng Yen (61,3%) [3], va eao han so vdi nghien cdu cua Doan Minh Loc (38,2%) [2]; Ket qua nghien edu cua ehung toi con cho thay d Ian sinh t h d nhat va t h U hai, sd ba me sinh dugc con trai deu cao hdn sd sinh con gai; nhu vay, mac du cd 83,6% ddi tUOng biet hau qua ciia LCGTTN, n h u n g phan Idn cap v d chdng van mong m u d n ed con trai. ThUc te nay cho thay, cd nhifng van de ngudi dan biet la cd hai cho Ipi ich chung cua xa hdi, song ngudi ta van lam vi lai ich rieng eua ca nhan. Day la m o t thach t h d c Idn cho cdng tac truyen t h d n g thay ddi hanh vi.
4.3. Ve thUc hanh lUa chpn gidi tinh thai nhi Trong lan sinh gan day nhat, cd 210 ngddi (18%;
tra Idi la ed LCGTTN, n h u vay, da cd m d t ty le kha cao eae ddi t u a n g nghien cdu Ida chon gidi tinh cho diia con cua m i n h ; ket qua nay edng phu hdp vdi ket qua nghien cdu cua Hoang Thi Khuyen (17,4%) [3].0ieu nay cd t h e ly giai duae vi Bae Giang va Hdng Yen deu nSm t r o n g t d p 10 t i n h cd TSGTKS cao nhatca nude, t r o n g sudt giai doan 2009 den 2012. Theo ket qua nghien cdu cua nhieu nha khoa hoc, tinh trang
TAP CHi Y DLrgc LAM SANG 108 T9P 9 - S6 1/2014
TSGTKS tang cao la d o cd su tac d d n g true t i e p cua eae cap v d chdng khi sinh con. Do cd nhdng hieu biet nhat d m h ve LCGTTN va vdi quyet t a m thdc hien m o n g m u d n cua m i n h , cac doi t u a n g se lua chon gidi t i n h cho dda eon eua ho [5].
5. Ket luan
Nghien edu 1.164 cap vg ehdng sinh con t r o n g 4 nam (tLrOl/2007 den 12/2011), tai 3 huyen ed ty sd gidi tinh khi sinh cao cho thay: Kien thUc: t y le ddi tuong biet hau qua ddi vdi xa hdi cua lua chon gidi tinh thai nhi edn han ehe, biet se gay thda nam, thieu nd (83,6%), eho rang khdng anh h u d n g gi den xa hpi (12,6%). Biet eae bien phap Ida chon gidi t i n h thai nhi kha cao (28%); Thai dp: Ty ie ddi t u o n g mong mudn cd con trai chiem Uu the (54,6%); ThUe hanh: Ty le eae cap v a ehdng lUa chpn gidi t i n h thai nhi trong lan sinh tiep theo la kha cao (18,0%).
Tai lieu t h a m khao
1. Christophe Z Guilmoto (2008), "Thay doi ty sd gidi tinh khi sinh d Viet Nam trong thdi gian gan day", Tdng quan cac bang chdng. Ha Ndi.
2. Boan Minh Ldc (2011), Nghien cdu cac yeu t d 5nh hudng den ty so gidi tinh khi sinh d mdt sd dia phuong va de xuat cac giai phap kiem soat mat can bang gidi tinh, De tai NCKH cap Bd.
3. Hoang Thi Khuyen (2012), Dieu tra, danh gia thdc trang va de xuat cac giai phap can thiep giam thieu MCBGTKS tinh Hung Yen, Oe tai NCKH cap tinh Hung Yen.
4. UNFPA (2010), Sex Ratio at Birth Imbalances in Vietnam: Evident from the 2009 Census, Ha Noi, August 2010.
5. UNFPA (2010), "Ty sd gidi tinh khi sinh d Chdu A vd Viet Nam", Tong quan tai lieu nham hudng dan nghien edu ve chinh sach. Ha Ndi.
u. Li, Shuzhuo (2007), Imbalanced Sex Ratio at Birth and Comprehensive Intervention in China, Report for UNFPA.
