Family health consequences of modernisation programmes in Black Thai communities.

Southeast Asian governments implement ambitious programmes to reduce population growth and maternal mortality in areas with large minority ethnic populations. Although some of these programmes introduce new social and health practices that meet their broader aims, they may pay inadequate attention to the protective and medically beneficial aspects of traditional practices. This study examined the decline of temporary matrilocality (zu kuay) among the Black Thai in Dien Bien, Vietnam, as a response to policies adopted under the government programme of Doi Moi ('modernisation'). The patrilocal, patrilinear cultural norms of the majority ethnic Kinh people were promoted and zu kuay discouraged at a time when heroin availability increased dramatically but harm reduction programmes were not yet in place. This historical coincidence appears to have heightened certain Thai women's vulnerability to marriages with HIV-positive injecting drug users. Policies and guidelines on marriage and reproductive health should take into account the role of minority ethnic traditions, as well as local health-seeking practices, in order not only to improve reproductive programmes but also to reduce HIV vulnerability.