Inequality in healthcare-seeking behavior among women with pelvic organ prolapse: A systematic review and narrative synthesis

Abstract

Introduction: Pelvic organ prolapse affects women’s quality of life in various aspects. However, the evidence on their healthcare-seeking behavior is limited. Therefore, this study aimed to review and synthesize the existing evidence on the healthcare-seeking behavior among women with pelvic organ prolapse. Methods: The electronic databases PubMed, African Journals Online, Cumulative Index to Nursing and Allied Health Literature, African Index Medicus and Directory of Open Access Journal and Google Scholar were searched for relevant literature. The retrieved evidence was synthesized using narrative synthesis approach. The characteristics of included studies and the level of healthcare-seeking behavior were summarized in a table and texts. Error bar was used to show the variability across different studies. Results: A total of 966 articles were retrieved among which only eight studies with 23,501 women (2,683 women with pelvic organ prolapse) were included in the synthesis. The level of healthcare-seeking behavior ranges from 21.3% in Pakistan to 73.4% in California, USA. The retrieved studies were conducted on four different study populations, used both secondary and primary data, and were conducted in six different countries. Error bar shows a variation in the percentage of healthcare-seeking behavior. Conclusions: The level of Health-care seeking behavior among women with pelvic organ prolapse is low in low-income countries compared to high income countries. The characteristics of the reviewed studies are very different from each other. We recommend a large-scale study with a sub-group analysis which will help to understand the healthcare-seeking behavior.