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Indian Journal of Community Medicine

A Comparative Study of Perception about Reproductive Tract Infections among Married Women in Rural, Urban and Urban Slum Areas

Author(s): A Srivastava, D. Nandan, A.K. Mehrotra, B.B. Maheshwari, S.K. Mishra

Vol. 29, No. 2 (2004-04 - 2004-06)

Abstract

Research Question: What is the difference in perception about RTIs among women of rural, urban and urban slum area?

Objectives: To study the perception about reproductive tract infection among married women.

Study Design: Cross Sectional study.

Setting: Village of Sainya block Agra, urban slum areas of Lohamandi, Agra and urban area of Lohamandi, Agra.

Participants: Married women in the reproductive age group of 15 to 45 years.

Sample Size: 345 women in which 115 women taken from each rural, urban and urban slum area.

Study Variables: Age, Marital status and parity.

Outcome Variable: Perception about reproductive tract infection and occurrence of vaginal discharge.

Statistical Analysis:Test of significance, Z test.

Results: Perception about Reproductive Tract Infection was responded correctly by 28.69 % rural, 74.78% urban and 45.22% urban slum women. Perception about vaginal discharge was correct 78.26% in urban women while 26.09% in rural and 30.43% in urban slum women, perception about side effect of vaginal discharge was correct 100% rural and urban while 97.39% in urban slum women. Occurrence of vaginal discharge was found with an average of -- 24% in all three areas.

Introduction

Reproductive health is a condition in which reproduction is accomplished in a state of complete physical, mental and social well being and not merely as the absence of disease or disorders of the reproductive process.

The poor health of Indian women is a concern on both national and individual level. It affects the next generation of citizens and workers. It reduces productivity, not only at the house hold level but also in the informal and formal economic sectors. Improving women's health is integral to social and economics sectors.

There are different types of reproductive tract infections : sexually transmitted diseases, infection such as candidiasis and bacterial vaginosis and infections associated with unhygienic delivery and other unsanitary practices. Women are not only more susceptible than men to these infection but are also more prone to develop complications, in part because infection in women is difficult to diagnose and is therefore more likely to go untreated. Reproductive tract infection can cause pelvic inflammatory diseases, problems with pregnancy and child birth, infertility and chronic pain. Sexually transmitted diseases specifically can lead to chronic abdominal pain, infertility and life threatening complications such as ectopic pregnancy and cervical cancer: HIV/AIDS and Syphilis may directly cause death.

Present study was done with an aim to find out perception of women about Reproductive Tract Infection and comparison was done in rural, urban and urban slum areas. Criteria for correct perception about reproductive tract infection was that it is associated with vaginal discharge, urethral discharge, lower abdominal pain and genital ulcers. For our study vaginal discharge was taken as the leading symptom. Criteria for correct perception about vaginal discharge was that any change in colour, amount and odour is taken as abnormal. Discharge with itching, change in colour of discharge with abdominal pain is regarded as abnormal. It may be associated with some gynaecological disorder or sexually transmitted diseases. Criteria for correct perception about side effects of vaginal discharge was that it may lead to infertility, cause weakness, tiredness and poor work performance.

Material and Methods

The study was conducted among 345 married women in reproductive age group of 15 to 45 years, 115 women from each area the rural, urban and urban slums were included in the study. The women in all three areas were randomly selected by visiting every third household and interviewing the married women. The interview schedule had part A and part B. Part A included the relevant biosocial characteristics, the part B included queries related to studied factors. A pilot study was carried out and necessary modifications were done in schedule before starting the study. In rural area the study was conducted in various villages of Sainya block, in urban slums the study was conducted in Jattu Bazaar, Shiv Nagar and Anand Nagar areas of Lohamandi, Agra. The study in urban area was carried out in women residing in urban area of Lohamandi, Agra.

Results

The perception about Reproductive Tract Infection was responded correctly by 74.78% urban, 28.69% rural and 45.22% urban slum women and difference was found to be significant (P<0.05) in all three areas.

Table I: Area wise Distribution of Perception About Reproductive Tract infection and vaginal discharge

Area- wise Distribution (N=345)
Perception Rural Urban Urban Slum Total
  N=115
n(%)
N=115
n(%)
N=115
n(%)
N=345
n(%)
Reproductive
Tract Infection
33(28.69) 86 (74.78) 52(45.22) 17 1(49.57)

Perception about cause of vaginal discharge was found to correct 78.26% in urban area while 26.09% in rural and 30.43% in urban slums (Table 1).

Table II : Area wise distribution of perception about vaginal discharge

Perception Rural
n(%)
Urban
n(%)
Urban
Slum
n(%)
Total
n(%)
Vaginal Discharge 30(26.09) 90(78.26) 35(30.43) 155(44.93)
Side effect of Vaginal Discharge 115(100) 115(100) 112(97.39) 342(99.13)

The difference was significant in all three areas perception about side effect of vaginal discharge was correct 100% in rural and urban while 97.39% in urban slum with significant difference between rural & urban & urban slums (p<0.05). The occurrence of vaginal discharge was found 54.78% in rural 43.48% in urban and 43.48% in urban slums with in average of 47.24% in all three areas.

Watery vaginal discharge was found in 67.74% rural 64% urban and 64% urban slum women and 22.58% rural, 20% urban and 24% urban slum women had curly discharge (Table II).

Table III: Area-wise Distribution of Type of Vaginal Discharge

Discharge Rural (631
n(%)
Urban(50)
n(%)
Urban Slum (50)
n(%)
Total(163)
n(%)
Offensive 3 (4.83) 2 (4) 3 (6) 8
Curdy 14 (22.58) 10(20) 12(24) 36
Waters 42 (67.74) 32(64) 32(64) 106
Mixed , 4(6.45) 6(12) 3(6) 13

Discussion

Perception about reproduction tract infection was maximum responded correctly by urban women. Education and better sources of communication in urban area may be the possible reason for that. Perception about vaginal discharge was also found to be correct maximum in two third urban women but perception about side effects of vaginal discharge was correct nearly among all women. This parallel the data according to study done by Bang et. al. (1989) for perceived effects of white discharge in which 95% of women reported correctly. Occurrence of vaginal discharge is parallel to study done by Patel et. al. (1994) in which women mentioned white discharge 48.8% in urban area while women in rural area mentioned white discharge 59.6% with an average of 56.6% in total. The type of vaginal discharge is parallel to socio­ clinical study of RTI-STD case done by Nandan D, et, al. (Nov. 1997), majority of women were having complaints of vaginal discharge. Of these maximum were having watery discharge (64.08%) while 29.13% were having complaints of curd like discharge. The discharge was offensive in only 1.94% cases while 4.85% reported mixed discharge.

Recommendations

Indigenous methods of sanitary pads like clean, sundried domestic cloths can be promoted during menstrual periods so that their economic conditions do not act as a barrier in the maintenance of hygiene. Emphasis should be given for psychosocial and physical development of girl child so that she may become a healthy, future mother of the community. Govt. sector of health services should be strengthened and widely approachable especially in the field of family welfare. For this involvement of health workers in family planning programmes should be intensified up to the village level and similarly the cooperation and involvement of Non Governmental Organization (NGOs) should also be sought.

References

  1. Bang RA. AT Bang, M. Baitule, Y Choudhary, S Sarmukkadam and O Tale: High Prevalence of Gynaecological Disease in Rural Indian Women. Lancet I (8629): 1989, 85-88.
  2. Farthalla MF : Planning now for better reproductive Health People, 1988.
  3. Hawkins & Bourne Shaw's Text Book of Gynaecological, disorders 1990
  4. Improving women's Health in India Development Practice (World Bank) 1996.
  5. Indian Council of Medical Research: Reproductive Health Monitoring System Draft Report of the Multi Centered Study, 1995.
  6. Park JE and Park K : Text Book of Preventive and social medicine, 14th edition M/s Banarsi Das BHanot, Jabalpur 1994.
  7. Nandan D: Improving reproductive Health and family specificance in the state of Uttar Pardesh : Socio-clinical study of RTI-STD cases.
  8. Patel BC, S Barge, R Kolhe and H Sadhwani: Listing to women talk about reproductive Health Problem in the Urban Slums and Rural Areas of Baroda, Gujarat 1994.
  9. Reproductive Health: A to a brighter future-Biennial Report 1990-91.
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