Nghi©n cuu<br />
O i a ' d l n h v4 Gi61<br />
sS 4 - 2 0 1 2<br />
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Viem nhiemflmimgsinh san cua phu niif dft boi sinh de<br />
khu vuc phia Tdy Hd Ndi: Thuc Irang vd gidi phdp<br />
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Doin Kim Th^ng<br />
Vi$n xa hdi hoc<br />
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Tom tiit: Bfii vict ducii day Ifi kfit qua cue cu^c khao sat "Danh gia<br />
thUc trang vifim nhifim dudng sinh san ciia phu ntt trong dp tuo'i<br />
sinh de {15-49) c6 chfing tai khu vyc phfa Tay Ha Not" nfim 2010<br />
nhflm muc dfch tim hifiu cfic yfiu to anh hudng tdi viem nhiem<br />
dUcJng sinh san vfi cfi nhttng giai phfip can thifip cho cae va'n de<br />
nfiy. Theo kd't qua nghifin cttu. c6 dfin hOn 2/5 phy ntt trong do tuoi<br />
sinh de mfic mgt trong cfic bfinh thupc nhdm VXDSS (48,2%) cho<br />
ibiiy dfiy tfi vfl'n dfi cfin luu tnm d^c bifit khi phUdng phfip chii dao<br />
de giam ty \v sinh trong cfic chUdng trinh KHHGD la "d$t vong<br />
trfinh thai". Nhttng khoang trd'ng trong nhfin thttc ve nguyen<br />
nhan gfiy benh vfi nhttng nhfin djnh chua dfiy du ve VXDSS da<br />
dfln den nhinin thfii dp khfing dung mi;c trong phong vfi dieu tri<br />
bgnh. \)v (ill llnfin tinh. nghifin cttu da dUa ra nhQng giai phap va<br />
kien nghi ve xa hpi vfi y le. Wot chUdng trinh giao due ve VNDSS<br />
hofin chinh cho cpng dmig cfln dugc xem la muc tieu trong tfim cua<br />
ChUdng trinh sttc khoe sinh san.<br />
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Tii khoa: Viem nhiem dUdng sinh san; Quan he tinh due; Chfim<br />
soc sttc khoe sinh san; Phu ntt dp tud'i smh de.<br />
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1. Dac diem nhan khau hoc - xa hoi m l u nghien ciiu<br />
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Viem nhilm dudng sinh san (VNDSS) la m6t nhom benh nhilm trttng<br />
kha phd bie'n b ntt gidi co ihe^ lien quan hoflc khdng lien quan de'n quan hd<br />
Doan Kim Thing 77<br />
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tinli due. VNDSS khflng chi 1^ m6t benh ly don thuSn cila du&ng sinh san<br />
mi n6 c6n gay ra nhiing rtfi loan trong d6i stfng vk sinh hoat tmh due cCia<br />
ngil6i phu nii. Vifim nhiSm dudng sinh .san bao gtfm e^ nhiSm trOng lay<br />
truydn qua dudng tinh due (STls).<br />
Theo itf chiic y ttfThtf gitfi (WHO) mtfi nam ctf khoang 250 Irieu ngutfi<br />
bi mac cac benh nay Tai Viet Nam, theo udc tinh ctf khoang 800.000 -<br />
l.OOO.OOO ngutfi mflc benh STIs mtfi nam, trong dtf vj thanh nien va thanh<br />
[tien chie'm khoiing 40%. Day la mtft thuc trang cfin bao dtfng btfi khi mac<br />
benh Sris ctf thd ISm ttfn thuong ttfi siic khoe sinh sSn ciia nam nii va ctf thd<br />
gay ra nhiing hau qua nghifim u-ong nhu v6 sinh, lay truydn t£r me sang con<br />
(khi ngutfi phu nii ctf thai) hoac ctf the' dSn dfi'n ttr vong (vifim gan vi rut B,<br />
C...).<br />
Tai Ha Ntfi, ty lc VNDSS cua phii nii nam 2009 la 43,7%. trong do khu<br />
vuc phia Tay Ha Ntfi la 45%. Mtft stf huyen thutfe khu viic phia Tay Ha Ntfi<br />
CO ty le VNDSS rit cao nhir: Dan Phuang (60,87%), Thach Tha't (51,4%),<br />
IJhg Hoa (68,81%), My Diic (67,73%) (Mo cio Chi cue DS-KHHGD Ha<br />
Ntfi, 2009). Ttt thuc irang uin. nam 2010 nghifin eiJu "Danh gia thirc trang<br />
vifim nhifim dutfng sinlt san ciia phu nii trong dtf tutfi sinh de (15-49) ctf<br />
chtfng tai khu vuc phia Tay Ha Ntfi" duoc tifi'n hanh nham muc dich tim hie'u<br />
cac yeu ttf anh hutfng ttfi viem nhiem dutfng sinh san de' co nhttng giai phap<br />
can thiep cho cac van di nSy.<br />
Dia ban nghifin cttu bao gtfm 6 xa la: Ba Trai (Ba Vi); xa Phu True (Phtt<br />
Xuyfin); xa Hoa Lam (Ung Hoa); xa Yfin Trung (Thach That); xa Thucmg MO<br />
(Dan Phuong), Phu Luang, quan Ha Dtfng. Cae xa duac chpn lam dia ban<br />
nghifin cttu ddu la cac xa thuSn ntfng, vtfi ty 16 htf lam nOng nghiep chifi'm ttt<br />
>70% dfi'n >80% dan stf nflng nghifip. Phu ntt trong dtf lutfi sinh de ctf chtfng<br />
tai cac xa khao sal dao dtfng ttt 18.4''; dfi'n 21.7%. Theo bao cao Ihtf'ng kfi lai<br />
Tram y le cac xa, ty lfi phu ntt VNDSS con kha cao nhu tf cac xa Htfa Lam,<br />
huyfin IJhg Hoa (57.29; nam 2009; 55.1', nam 2010): xa Phu Tnic, huyen<br />
Phu Xuyen (65.0% nam 2009; 70,0% nam 2010) ..Tfnh den 6 thang dSu<br />
nam 2010, ty le sinh con thii 3 trtf 16n cung ctfn kha cao tf cac xa nhu: Hoa<br />
Lam huyen Ong Hoa (23.5%); Phii Luong, quan Hil Dflng (17,2%) va Ba<br />
Trai, huyfin Ba Vi (10,2%)... (Bao cao thfl'ng ke, 2010).<br />
Trong tong stf 800 phu ntt dugc phtfng va'n. phu ntt dtf tuoi ttt 25 - 34<br />
chiein ty lfi cao nha't (39,4%); do tuoi 35- 44 (32,7%); phu ntt dtf tufli 44 trtf<br />
lfin (14,2%) va phu ntt ttt 1.5-24 tuoi ctf ly le tha'p nha't (13.4%).<br />
7« NghlSn eiiu Gla dlnh vk GIdl. Quyin 22, • « 4, tr.76-86<br />
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Phu ntt dupc htfi ctf trtnh dtf hoc vin cSp II chiem ty le cao nha't irong<br />
mSu nghifin cttu (67,8%); dp III (21,2%); cSp I (7.3%) vi 3.4% phu ntt ctf<br />
irlnh dtf Cao ding/Dai hoc. Stf phu ntt khtfng bi« d