# Adolescent sexual and reproductive health and rights policy for ethnic minority girls in Vietnam: a qualitative study with policy makers and service providers

## TL;DR

This study explores how to improve sexual and reproductive health policies for ethnic minority adolescent girls in Vietnam by addressing socio-cultural barriers and policy implementation challenges.

## Contribution

The study provides new insights into the perspectives of policymakers and service providers on improving ASRHR policy for ethnic minority adolescent girls in Vietnam.

## Key findings

- Conservative patriarchal values and parenting practices contribute to health inequities among ethnic minority adolescent girls.
- Universal ASRHR policy responses fail to address the specific needs of ethnic minority communities.
- Strengthening policy includes provincial-level improvements and better use of civil society resources.

## Abstract

Adolescent sexual and reproductive health and rights (ASRHR) policy has strengthened globally over the last three decades, but country-level barriers to implementation perpetuate health inequities for adolescent girls. In Vietnam, implementation of ASRHR policy remains challenged by persisting structural and socio-cultural issues and has yet to reduce the high prevalence of adolescent pregnancy in ethnic minority communities.

To explore the perspectives of policy makers and service providers in Vietnam regarding the factors influencing the delivery of ASRHR policy for ethnic minority adolescent girls. The research examined professional opinions related to: (1) socio-cultural factors influencing the lives of adolescent girls in Vietnam; (2) current implementation of ASRHR policy for ethnic minority girls; and (3) strengthening ASRHR policy and service delivery for this population.

Eleven key informant interviews were conducted across government and civil society, using semi-structured interviews via an online platform. Critical qualitative inquiry guided a reflexive approach to thematic analysis.

Three themes were constructed. First, conservative patriarchal values, parenting, and particular vulnerabilities of ethnic minority girls underpin health inequities. Second, universal responses to ASRHR policy weaken delivery of services and education in ethnic minority communities and are not responsive to emerging complexities. Third, strengthening ASRHR policy in Vietnam includes provincial level enhancements and better use of civil society resources.

Key informants strongly supported ASRHR policy in Vietnam and called for improved policy level action to contextualize complexities and better use of available local resources. The recommendations could contribute to strengthening ASRHR policy in Vietnam.

Main findings: Important socio-cultural factors still affect the lives of adolescent girls in Vietnam and practical and feasible recommendations are offered to improve equitable sexual and reproductive health service delivery for ethnic minority adolescent girls.Added knowledge: This study addresses a neglected perspective on the determinants affecting positive sexual and reproductive health outcomes for adolescent girls in Vietnam, by exploring the experience and perspectives of key informants who implement adolescent sexual and reproductive health and rights policy in ethnic minority communities.Global health impact for policy and action: Improving the effectiveness of adolescent sexual and reproductive health policy in complex and diverse socio-cultural contexts would benefit from better use of local resources and closer policy-level attention to subnational factors.

Main findings: Important socio-cultural factors still affect the lives of adolescent girls in Vietnam and practical and feasible recommendations are offered to improve equitable sexual and reproductive health service delivery for ethnic minority adolescent girls.

Added knowledge: This study addresses a neglected perspective on the determinants affecting positive sexual and reproductive health outcomes for adolescent girls in Vietnam, by exploring the experience and perspectives of key informants who implement adolescent sexual and reproductive health and rights policy in ethnic minority communities.

Global health impact for policy and action: Improving the effectiveness of adolescent sexual and reproductive health policy in complex and diverse socio-cultural contexts would benefit from better use of local resources and closer policy-level attention to subnational factors.