SOCIAL AND REPRODUCTIVE PORTRAIT OF RURAL YOUTH

1Аbilkhas A.А., 1Apen N.M., 2Shamsutdinova A.G.

1Asfendiyarov Kazakh National Medical University, 2Scientific-research institute of fundamental medicine named after academician B. Atchabarov, Almaty, Kazakhstan

Introduction. The period of formation of reproductive health and behavior is one of the most critical periods in the biological, psychological and social development of man. In general 27.5% of the republic population is youth. The proportion of young people among the urban population is 27.7%, among the rural population 27.3%, recently the number of rural youth is decreasing[1]. This is due to the outflow of young people for the purpose of further education and employment. In the city youth with rural origin meets a lot of social, economic, health and reproductive issues. That was the purpose of the social project "Adaptation of rural youth in the metropolis", to reveal the potential issues and find the way of their solution, as well as clarification of adolescents and youth awareness of reproductive health.

Methods. We developed 2 questionnaires: for girls, consisting of 36 questions, and for boys, consisting of 33 questions. Questionnaires developed in Russian and Kazakh languages. Student survey was held online from February to December 2016 and everyone could keep their anonymity. Any student could join it from any device. A computer program was developed to carry out an anonymous online questionnaire and adapted to Android and iOS mobile applications. On every closed-ended question a student could choose only one answer. Some questions implied the answer "Other". In this case a student could type his own answer. It's unable to go to the next question without answering the previous one. Some questions provide for the expansion, with a positive response is an in-depth question. Statistical analysis was performed by using SPSS software (Statistical Package for Social Science). Partly filled questionnaires wasn't taken for statistical analysis.

Confidentiality of all respondents was provided, it was student's decision whether to continue the survey or not. The process took less than 15 minutes.

2087 questionnaires were received during the survey, 31 of them were culled, thus 2056 questionnaires passed statistical processing.

Results. 798 young men (38.8% of all respondents) took part in the survey. Two thirds or 64.9% of respondents were under the age of 20, one third or 33.9% were from 20 to 24 and 1.2% were older than 25.

Thus 98.8% of the respondent's can be classified as "youth".

Most of surveyed students (94.6%) study at the four universities located in Almaty: Asfendiyarov KazNMU, Kazakh SWTTU, Al-Farabi KazNU, Satpayev KazNTU and  little more than 5.4% are students of other universities. Before entering the university nearly a third of respondents  (31.5%) lived in the city, and nearly two thirds (68.5%) lived in the countryside. This allowed us to turn to the youth, who came from the countryside to the city to study.

There is a social portrait of respondents: almost half of respondents (46.4%) grew up in families with 3-4 children, every third respondent (31.6%) is a student from the family with 5 children, and only a little more than 2% (2.4%) make up a family with 1-2 children.

More than half of respondents (53.6 %) pointed that they live in families with high material prosperity, 37.5 % of respondents live in families with average incomes, 5.7 % of students pointed a minimum level of material prosperity, and 3.1% of students pointed that parents are separated and have different levels of material prosperity.

Half of respondents (50%) live in the hostel, 26.1% of students live with relatives, 16% rent an apartment and only 8% live with their parents.

Two thirds of respondents (65.5 %) indicated that they don't have enough money to stay in the city, almost one in five respondents (19.9 %) pointed that money is not always enough, 14.6 % of students pointed that they have sufficient funds to stay in Almaty.

Despite the fact that two thirds of respondents (65.5%) indicated the lack of funds to stay in the city, only half (52.1%) of young people would like to combine study with work, 2.6% indicated that they would like to combine, but only on a holidays, or it would be better to enroll in additional courses or don't have enough time due to sports; 45.3% of respondents answered that they don't want to combine study with work.

44.6% of young people had problems with the study first few months, 16.8% pointed out the housing problems, 11.8% of students had problems with poor knowledge of Russian language, 6.6% of respondents had problems with fellow students.

Knowledge of contraception: 36.9% of respondents answered that they know about preventing unwanted pregnancy just in general, 37.2% of respondents know almost everything, 25.9% answered that they first heard about it. To the question "Who told about methods of prevention of unwanted pregnancy?" every third respondent said that she had learnt about contraception from her parents (31.0 %), friends (34.2 %) and the Internet(34.2 %).

As a result of the survey, 67.9% of young men pointed that they have sexual relations and 33.1% aren't sexually active, while in 24.2% first sexual intercourse occurred at the age of 17± years and in 6.9% the reason was alcohol intoxication. 30.3% of sexually active students answered that they had only one partner, 38.2% had two partners and 31.5% had three or more partners. The most popular method of contraception was rejected sexual intercourse - 30.6%, 28.6% use condoms. 33.4% of respondents don't prevent unwanted pregnancy and STDs.

We asked: "What would you do if your girlfriend will get pregnant?", 53.2% of respondents don't know the answer, 21.7% would go to the private medical centers, 1.7% would go to the student clinic. More than half of respondents aren't ready for such responsibility.

Conclusion. In the course of the survey we were able to turn to the study group - young men who came from the countryside to study in the city. During data processing we revealed that the vast majority of students have an acute problems of everyday life, especially in the first year of study. Unfortunately a quarter of respondents began their sexual life before the age of 18. The usage of contraception in sexually active students is low, one third of them use inefficient method - rejected sexual intercourse. The disturbing fact is that more than half of respondents have two or more sexual partners, which increases the risk of STDs. Also most of them have no sense of responsibility to the sexual partner, many of them don't even know what to do if their girlfriend gets pregnant. Therefore there is an acute need for a proper and correct informing young people on reproductive and sexual health in compliance with the principles of confidentiality. Research on the readiness of parents, teachers and health workers to provide adolescents with information on reproductive health and safe sex show that they aren't ready to discuss sexuality with teenagers, often because they feel uncomfortable or overworked, or they don't approve of the interest of young people on sexuality.

Medical students with proper training could become a force in supporting the implementation of programs "peer to peer". Free access to the information resources is an essential component of improving reproductive attitudes and behavior of young men. Establishment and improvement of the material conditions of study, work and leisure of young people is the primary task of universities and city administrations, the solution of which is possible with the assistance of sponsors following the example of the leading universities of the world.

References

1.  The statistical data of the Agency of Statistics of the Republic of Kazakhstan, 2013.

2.  Katy Mitchell. Adolescent Sexual and Reproductive Health Toolkit for Humanitarian Settings, 2009.