| Objective:To understand the status of reproductive health knowledge, attitudes, behaviors, and demand for reproductive health services among unmarried migrant female in China, to analysis and compare the influencing factors of the occurrence of premarital sex, to find intervention strategies to improve the reproductive health level of unmarried migrant female and to assess its'intervention effects, so to provide scientific evidences for developing policies for the relevant government departments.Methods:â… . Survey on reproductive health KAP and demand for reproductive health service among unmarried migrant female:both of quantitative and qualitative methods were used. A total sample of 5156 unmarried migrant female workers from three factories, with one in Guangzhou and two in Shenzhen, were obtained by simple random sampling. A self-designed questionnaire was conducted to measure the subjects'reproductive health knowledge, attitudes, behaviors, demands for reproductive health services etc. Additionally, the interview was conducted as qualitative method.â…¡. A comparative study on reproductive health status among unmarried migrant female from different regions of China:to analysis the different status of reproductive health knowledge, attitudes, behaviors and the demand for health services between the unmarried female from the central region and the western region of China, to find the influencing factors of the occurrence of premarital sex and to compare the factors stratified by regions.â…¢. A community-based comprehensive intervention pilot to improve the reproductive health of unmarried migrant female:a big factory located on Shenzhen which separate into two parts was selected as the research sites, of 402 and 449 unmarried migrant females were obtained as intervention and control group from the two parts, respectively. The intervention included distributing promotional materials, organizing lectures and peer-education, offering counseling and contraceptive services, and so on. The intervention activities lasted 6 months, the total follow-up rate was up to 85.9%. Questionnaire surveys were carried out before and after intervention to evaluate the effect of the intervention project, and summarizing the process of the intervention project to assess the feasibility of the intervention model.Results:â… . Unmarried migrant female lacks of reproductive health knowledge. There were only 15.9% of the participants knew "the easiest pregnant period of a normal menstruation women ", only 38.4% knew that the characteristic symptoms of the early pregnancy; less than 40% can tell four or more contraceptive methods,40.3% of unmarried women did not know or did not realize the impact of abortion. Most unmarried migrant female had heard of AIDS, common sexually transmitted diseases, however, they lacked of comprehensive understanding of symptoms and transmission of AIDS and STD.â…¡. The attitude towards premarital sex among unmarried migrant female were more open than that in the previous studies. There were 31.9% and 14.2%of the subjects held a favorable attitude towards premarital sex, and premarital pregnancy, respectively. The attitude towards premarital sex among unmarried migrant female were still traditional, however, compare with the previous study, their relative attitudes were more open.â…¢. The premarital sex rate and abortion rate were high among unmarried female. The self-reported premarital sex rate was 16.9%, and the self-reported abortion rate was 26.4% among the unmarried migrant female who had reported premarital sex. â…£. The need and demand for reproductive health care services in unmarried migrant female was unmet. There were 85.3% subjects thought it is necessary to provide reproductive health knowledge, counseling, and contraceptive service to them, including 58.4% of the subjects demand for correct information on reproductive health,32.9% of them need contraceptive counseling, and 32,2% of the subjects demand for gynecological examination services.â…¤. Significant difference on reproductive health knowledge, attitudes, and prevalence rate of premarital sex existed between central and western regional of China. The influencing factors of premarital sex included whether or not have boyfriend, age, how long they had left their home, the availability of contraceptives on the place where they live now, type of living conditions, knowledge scores on contraceptive and AIDS/STD, education level, communicate sexual and reproductive health topic with boyfriend, attitude to premarital sex. Additionally, the factors of premarital sex among unmarried migrant female from the central were different from that among unmarried migrant female from the western part of China central.â…¥. It is feasible and effective to carry out reproductive health service among unmarried migrant female based on community health service, however, there were still some limitations. The feasibility was reflected in the following aspects:First, as community health services have a good mass base, youth friendly services of reproductive health are easy to implement. Second, the accessibility of reproductive health services provided by community health service is good. Third, the medical staffs of the community health service organization are easy to establish a trust relationship with the unmarried population, which is conducive to carry out health care service. Fourth, it is low cost to see a doctor at community health service center. Fifth, after the intervention which lasted 6 months, we found that the reproductive health knowledge was improved significantly among the subjects in the intervention groups, more subjects in the intervention group disapproval of premarital sex, and the premarital sex prevalence rate decreased. The limitations reflected in the following aspects:First, government supports and investment are needed to carry out sexual and reproductive health service in the form of health education and counseling; however, the government may not invest enough money to build reproductive health system for unmarried migrant population in a short period. Second, it lacks of a group of medical staffs to carry out reproductive health service special for unmarried migrant population. Third, community health is a demand-oriented organization, so the community services orientation are different among different types of communities. Fourth, the short-term effect of sexual and reproductive health interventions were proven to be effective, however, further studies are needed to explore whether the long-term effective exist or not.Conclusions and suggestions:â… . The reproductive health status of unmarried female migrants is on no way of optimistic, which should be focused by all sectors of the community. Take the sexual and reproductive health of unmarried migrant population into the urban health service and management system, and increase investments to perfect the system gradually.â…¡. Unmarried female migrants lack of productive health knowledge, and they only have simple way of obtaining those knowledge, thus, advocating the'School-Family-Society'model of education is imperative. It may be helpful to make the unmarried migrant population learn more sexual and reproductive health from school, family and social education play auxiliary role in sexual education, which can strengthen the effects of sexual education from school.â…¢. Multi-sectoral collaboration is needed to promote sexual and reproductive health level. Family planning departments and health departments are the main provider of the reproductive health service, however, among the unmarried population, the accessibility and acceptability of the sexual health service are poor, their need for sexual health services are changed from time to time, and it is difficult to manage the unmarried migrant population. Therefore, it is necessary that all the social sectors should work together to promote sexual and reproductive health level of unmarried migrant population. â…£. Youth or adolescent friendly service is advocated. The accessibility of reproductive health service are improved among unmarried migrant population through establish a broad-friendly information and service. Because of'embarrassment', many unmarried persons missed the chance of access to sexual and reproductive health service. The unmarried migrant population will consider the medical technology, privacy protection, price, service attitude, the medical environment, waiting time, convenience and so on when they choose sexual and reproductive health services, all of which reflect that they are eager for youth friendly service.â…¤. To improve the reproductive health level of the unmarried migrant, further study is needed which should be carried out by combining practice.Innovations:â… . It is the first time to clarify the different status and influencing factors of the reproductive health between the unmarried population from the central and the western of China.â…¡. Taking the leading in trying to carry out reproductive health interventions among unmarried females based on community health service.
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